Kody Anderson Valid NPI

Individual provider · Athletic Trainer · Dekalb, IL

NPI

1902384936

Type

Individual (Type 1)

Primary specialty

Athletic Trainer (Specialist/Technologist)

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

2255A2300X

License number

096003785 (IL)

Sex

Male

Sole proprietor

No

Enumerated

2018-08-01

Last updated

2018-08-01