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1972992295
CODY ROBERT CORNTASSEL
WACO, TX
NPI
1972992295
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TX AT5653)
Enumeration Date
2015-01-12
Last Update Date
2015-01-12
Business Address
Mr. CODY ROBERT CORNTASSEL ATC, LAT
415 OWEN LN APT 713
WACO, TX 76710-8910
Phone number: 918-961-1527
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Mailing Address
Mr. CODY ROBERT CORNTASSEL ATC, LAT
415 OWEN LN APT 713
WACO, TX 76710-8910
Phone number: 918-961-1527
Copy
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