Individual
CODY ANDREIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
2200 BONFORTE BLVD, PUEBLO, CO 81001-4901
(719) 242-4364
Mailing address
1316 N RAYNOLDS AVE, CANON CITY, CO 81212-8425
(719) 242-4364
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.0002476
CO
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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