Individual
DR. CODY CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
11 E AUGUSTA PL, GREENVILLE, SC 29605-1755
(864) 916-0203
Mailing address
620 HALTON RD, APT 14305, GREENVILLE, SC 29607-3440
(706) 264-0670
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
.8242 PT
SC
225100000X
Physical Therapist
PT012367
GA
Other
Enumeration date
06/27/2016
Last updated
06/27/2016
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