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NPI 1740674845

NPI 1740674845 : CODY JAMES ZINK ATC : HARLAN, IN

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General NPI Number Information
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    NPI Number           |    1740674845
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    Entity Type          |    Individual 
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    Provider Name        |    CODY JAMES ZINK ATC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/26/2015
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    Last Update Date     |    05/31/2016
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Provider Practice Location Address
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    Address Line         |    24502 STATE ROAD 37 
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    City                 |    HARLAN
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    State                |    IN
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    Zip                  |    46743-9753
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    Country              |    US
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    Telephone            |    260-452-4112
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    24502 STATE ROAD 37 
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    City                 |    HARLAN
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    State                |    IN
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    Zip                  |    46743-9753
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    Country              |    US
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    Telephone            |    260-452-4112
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    
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    License Number State |    IN
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