Provider Demographics
NPI:1710324538
Name:HOBELMAN, CODY
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:HOBELMAN
Suffix:
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 1:709 EVERETT
Mailing Address - Street 2:
Mailing Address - City:FIRTH
Mailing Address - State:NE
Mailing Address - Zip Code:68358-6220
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:709 EVERETT
Practice Address - Street 2:
Practice Address - City:FIRTH
Practice Address - State:NE
Practice Address - Zip Code:68358-6220
Practice Address - Country:US
Practice Address - Phone:402-202-0765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1678225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist