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1538696273
CODY GROTEWOLD
STATESBORO, GA
NPI
1538696273
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: GA AT002778)
Enumeration Date
2017-05-12
Last Update Date
2019-08-05
Business Address
CODY GROTEWOLD MS, ATC, LAT
590 HERTY LANE
STATESBORO, GA 30460-3783
Phone number: 912-478-5053
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Mailing Address
CODY GROTEWOLD MS, ATC, LAT
224 LANIER DR
STATESBORO, GA 30458-3783
Phone number: 912-478-5053
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