Individual
CODY AHLGRIMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
3200 W 7TH AVE, CORSICANA, TX 75110-4899
(719) 510-9762
Mailing address
704 N 14TH ST, CORSICANA, TX 75110-3844
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT8056
TX
Other
Enumeration date
02/19/2019
Last updated
05/05/2020
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