Cody Wickenhauser, PT, DPT

NPI #1811364052 in Bloomington, Illinois

Provider Information

NPI Number: 1811364052
Entity Type: Individual
Name: Cody Wickenhauser, PT, DPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT, DPT
Enumeration Date: Aug 24, 2015
Last Updated: Aug 24, 2015

Practice Location

Address: 2406 E EMPIRE ST
City: Bloomington
State: Illinois
ZIP Code: 61704-3630
Phone: (309) 663-9300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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