MR. Cody Robert Corntassel, ATC, LAT

NPI #1972992295 in Waco, Texas

Provider Information

NPI Number
1972992295
Entity Type
Individual
Name
MR. Cody Robert Corntassel, ATC, LAT
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Specialist/Technologist - Athletic Trainer
Credential
ATC, LAT
Enumeration Date
Jan 12, 2015
Last Updated
Jan 12, 2015

Practice Location

Address
415 OWEN LN APT 713
City
Waco
State
Texas
ZIP Code
76710-8910
Phone
(918) 961-1527

Specialties & Taxonomy Codes

Specialty
Specialist/Technologist - Athletic TrainerAthletic Trainer

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