Cody Mattingly

NPI #1952889685 in Boise, Idaho

Provider Information

NPI Number: 1952889685
Entity Type: Individual
Name: Cody Mattingly
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Aug 3, 2018
Last Updated: Feb 25, 2021

Practice Location

Address: 1475 N COLE RD
City: Boise
State: Idaho
ZIP Code: 83704-8537
Phone: (208) 809-2880

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant - Medical — Medical	363AM0700X
Physician Assistant	363A00000X	Primary

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