Provider Demographics
NPI:1407266067
Name:ESTEP, KODY I
Entity Type:Individual
Prefix:MR
First Name:KODY
Middle Name:
Last Name:ESTEP
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2580 E AMBUSH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-3667
Mailing Address - Country:US
Mailing Address - Phone:775-910-3037
Mailing Address - Fax:
Practice Address - Street 1:2580 E AMBUSH ST APT 4
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-3667
Practice Address - Country:US
Practice Address - Phone:775-910-3037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner