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General NPI Number Information
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NPI Number | 1629758792
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Entity Type | Individual
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Provider Name | CODY KOST
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Gender | Male
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 616 10TH ST E
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City | BRADENTON
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State | FL
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Zip | 34208-2110
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Country | US
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Telephone | 941-289-9015
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Fax |
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Provider Business Mailing Address
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Address Line | 2710 4TH AVE E
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City | BRADENTON
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State | FL
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Zip | 34208-1804
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Country | US
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Telephone | 941-666-1660
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP4492
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License Number State | FL
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