Provider Demographics
NPI:1720606874
Name:FEHRMAN, CODY (DC)
Entity Type:Individual
Prefix:DR
First Name:CODY
Middle Name:
Last Name:FEHRMAN
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 1:1025 WOODRUFF RD STE A104
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-4133
Mailing Address - Country:US
Mailing Address - Phone:740-630-4350
Mailing Address - Fax:
Practice Address - Street 1:1025 WOODRUFF RD STE A104
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-4133
Practice Address - Country:US
Practice Address - Phone:740-630-4350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557592111N00000X
SC4717111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor