Provider Demographics
NPI:1033735519
Name:ELENZ, CODY MICHAEL (DC)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:MICHAEL
Last Name:ELENZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 SCENIC HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-6617
Mailing Address - Country:US
Mailing Address - Phone:254-258-2295
Mailing Address - Fax:
Practice Address - Street 1:10200 EASTERN SHORE BLVD STE 106
Practice Address - Street 2:
Practice Address - City:SPANISH FORT
Practice Address - State:AL
Practice Address - Zip Code:36527-5816
Practice Address - Country:US
Practice Address - Phone:251-621-4037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14054111N00000X
TX14429111N00000X
AL2811111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor