| NPI | 1376146373 | 
|---|---|
| Professional Name | CODY M BENEDICT | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3756) | 
| Additional Taxonomies | 152W00000X Optometrist (Licence: WI 3652-35) | 
| Enumeration Date | 2020-11-20 | 
| Last Update Date | 2022-02-25 |