Individual provider · Type 1 NPI
Cody Wallace
Student in an Organized Health Care Education/Training Program · Hampshire, IL
NPI number
1386182038
Active
Practice location
12N854 Meadowlark Dr
Hampshire, IL 60140-8919
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Athletic Trainer | 2255A2300X | None listed |
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
About NPI 1386182038
Cody Wallace's National Provider Identifier is 1386182038, issued on Feb 2, 2017. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Hampshire, IL. The record was last updated on Feb 2, 2017.