MR. Cody Randall Pontius, MED, ATC, LAT
NPI #1023542891 in Ponte Vedra, Florida
Provider Information
- NPI Number
- 1023542891
- Entity Type
- Individual
- Name
- MR. Cody Randall Pontius, MED, ATC, LAT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- MED, ATC, LAT
- Enumeration Date
- Apr 18, 2017
- Last Updated
- Apr 18, 2017
Practice Location
- Address
- 460 DAVIS PARK RD
- City
- Ponte Vedra
- State
- Florida
- ZIP Code
- 32081-0544
- Phone
- (904) 547-7387
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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