Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CODY WALLACE
ActiveCODY WALLACE is a Student (Health Education/Training) healthcare provider located in HAMPSHIRE, Illinois. NPI 1386182038 is currently active in the NPPES registry. Verify at CMS.
Student (Health Education/Training) · HAMPSHIRE, IL
Registration Details
- NPI Number
- 1386182038
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 2, 2017 (9.5049925246984 yrs)
- Last Updated
- Feb 2, 2017
Practice Information
- Address
-
12N854 MEADOWLARK DRHAMPSHIRE, IL, 601408919Browse IL providers · Browse ZIP 60140
- Phone
- 8476526743
- Primary Specialty
-
Student (Health Education/Training)
390200000X
- Additional Specialty
- Student (Health Education/Training)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.