Provider Demographics
NPI:1740674845
Name:ZINK, CODY JAMES (ATC)
Entity type:Individual
Prefix:MR
First Name:CODY
Middle Name:JAMES
Last Name:ZINK
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24502 STATE ROAD 37
Mailing Address - Street 2:
Mailing Address - City:HARLAN
Mailing Address - State:IN
Mailing Address - Zip Code:46743-9753
Mailing Address - Country:US
Mailing Address - Phone:260-452-4112
Mailing Address - Fax:
Practice Address - Street 1:24502 STATE ROAD 37
Practice Address - Street 2:
Practice Address - City:HARLAN
Practice Address - State:IN
Practice Address - Zip Code:46743-9753
Practice Address - Country:US
Practice Address - Phone:260-452-4112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-26
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
IN2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer