Provider Demographics
NPI:1023379401
Name:LONG, CODY JONES (ND)
Entity Type:Individual
Prefix:DR
First Name:CODY
Middle Name:JONES
Last Name:LONG
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16857 E SAGUARO BLVD
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-6616
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:888-405-4584
Practice Address - Street 1:16857 E SAGUARO BLVD
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-6616
Practice Address - Country:US
Practice Address - Phone:714-244-6062
Practice Address - Fax:888-405-4584
Is Sole Proprietor?:No
Enumeration Date:2012-06-02
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18-1696175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath