Provider Demographics
NPI:1760083125
Name:HORTON, CODY JOE (OTD)
Entity Type:Individual
Prefix:DR
First Name:CODY
Middle Name:JOE
Last Name:HORTON
Suffix:
Gender:M
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 ALICIA DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-8640
Mailing Address - Country:US
Mailing Address - Phone:870-926-3780
Mailing Address - Fax:
Practice Address - Street 1:1871 FALLS BLVD N
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-4026
Practice Address - Country:US
Practice Address - Phone:870-208-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist