Provider Demographics
NPI:1245798438
Name:CODDINGTON, NICOLE CHRISTINE (LAT, ATC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:CHRISTINE
Last Name:CODDINGTON
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:CHRISTINE
Other - Last Name:ARZBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAT, ATC
Mailing Address - Street 1:5201 BRIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-5650
Mailing Address - Country:US
Mailing Address - Phone:414-520-6163
Mailing Address - Fax:
Practice Address - Street 1:2401 S 31ST ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76508-0001
Practice Address - Country:US
Practice Address - Phone:254-724-9585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73682255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer