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NPI Code Detail

MEDICARE: JORDAN CODY

MEDICARE: JORDAN CODY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5528OK

General Provider Information

NPI Number : 1477274280
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN CODY
Provider Business Mailing Address
First Line : 2150 W ELK AVE
Second Line :
City : DUNCAN
State : OK
Zip : 73533-1827
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2150 W ELK AVE
Second Line :
City : DUNCAN
State : OK
Zip : 73533-1827
Country : US
Telephone Number : 580-251-8460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2022
Last Update Date : 09/09/2022

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Directions to “ JORDAN CODY ” Practice Location

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