Provider Demographics
NPI:1679052914
Name:WARNECKE, CODY (DPT)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:WARNECKE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 BEECHER ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-3917
Mailing Address - Country:US
Mailing Address - Phone:567-712-3074
Mailing Address - Fax:
Practice Address - Street 1:7595 COUNTY ROAD 236
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-8738
Practice Address - Country:US
Practice Address - Phone:567-712-3074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT017652225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPT017652OtherSTATE LISCENSE