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1366918823
CODY RYAN HARLAN
ANDERSON, IN
NPI
1366918823
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: IN 36002859A)
Enumeration Date
2018-10-22
Last Update Date
2018-10-22
Business Address
CODY RYAN HARLAN LAT, ATC
1100 E 5TH ST
ANDERSON, IN 46012-3462
Phone number: 260-578-0144
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Mailing Address
CODY RYAN HARLAN LAT, ATC
740 MANCHESTER AVE
WABASH, IN 46992-1419
Phone number: 260-578-0144
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