MR. Cody Conrad Merrill, PTA

NPI #1356042386 in Oregon, Illinois

Provider Information

NPI Number: 1356042386
Entity Type: Individual
Name: MR. Cody Conrad Merrill, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Mar 16, 2023
Last Updated: Mar 16, 2023

Practice Location

Address: 811 S 10TH ST
City: Oregon
State: Illinois
ZIP Code: 61061-2129
Phone: (815) 732-7994

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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