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General NPI Number Information
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NPI Number | 1760211130
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Entity Type | Individual
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Provider Name | CODY BRIAN DINGMAN DPT
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Gender | Male
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Dates
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Enumeration Date | 08/01/2024
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 213 LIGHTWOOD RD STE 2
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City | DEATSVILLE
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State | AL
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Zip | 36022-3800
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Country | US
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Telephone | 334-543-4269
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Fax | 334-543-4272
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Provider Business Mailing Address
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Address Line | 7697 UPPER RIVER RD
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City | TALLASSEE
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State | AL
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Zip | 36078-3453
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Country | US
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Telephone | 334-799-5853
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Fax | 334-239-4478
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTH11959
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License Number State | AL
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