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NPI Code Detail

MEDICARE: CODY WELLS DPT

MEDICARE: CODY WELLS DPT
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 Therapist

General Provider Information

NPI Number : 1629568217
Entity Type Code : Individual
Provider Name (Legal Business Name) : CODY WELLS DPT
Provider Business Mailing Address
First Line : 414 PENCO RD
Second Line :
City : WEIRTON
State : WV
Zip : 26062-3822
Country : US
Telephone Number : 304-723-3780
Fax Number : 304-723-4110
Provider Business Practice Location Address
First Line : 414 PENCO RD
Second Line :
City : WEIRTON
State : WV
Zip : 26062-3822
Country : US
Telephone Number : 304-723-3780
Fax Number : 304-723-4110
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2018
Last Update Date : 05/18/2018

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Directions to “ CODY WELLS DPT” Practice Location

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