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1235744913
CODY DEARDORFF
LUBBOCK, TX
NPI
1235744913
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TX AT7951)
Enumeration Date
2020-09-10
Last Update Date
2020-09-10
Business Address
CODY DEARDORFF MAT, LAT, ATC
3211 47TH ST
LUBBOCK, TX 79413-4112
Phone number: 806-219-2042
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Mailing Address
CODY DEARDORFF MAT, LAT, ATC
13407 INDIANA AVE APT 2108
LUBBOCK, TX 79423-1869
Phone number: 806-787-7828
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