Cody Wickenhauser, PT, DPT

NPI 1811364052 · on the registry since 2015

Practice

Address: 2406 E Empire St
Bloomington, IL 61704
Phone: (309) 663-9300
Fax: (309) 663-6993
Organisation at this address: Millennium Pain Center Llc
Bromenn Physician Management Corporation
Orthopedic And Sports Enhancement Center, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 10

Registry record

Primary taxonomy: 225100000X
225100000X
Licence states on file: IL
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2015-08-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois