Individual
CODY DANIEL KLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPNP-PC
Contact information
Practice address
962 JOE FRANK HARRIS PKWY SE STE 105, CARTERSVILLE, GA 30120-2141
(470) 315-4201
Mailing address
2812 CRAIGIE AVE, APT D, DECATUR, GA 30030-3931
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN301315
GA
Other
Enumeration date
12/03/2021
Last updated
12/03/2021
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