Provider Demographics
NPI:1760211130
Name:DINGMAN, CODY BRIAN (DPT)
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:BRIAN
Last Name:DINGMAN
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 1:7697 UPPER RIVER RD
Mailing Address - Street 2:
Mailing Address - City:TALLASSEE
Mailing Address - State:AL
Mailing Address - Zip Code:36078-3453
Mailing Address - Country:US
Mailing Address - Phone:334-799-5853
Mailing Address - Fax:334-239-4478
Practice Address - Street 1:213 LIGHTWOOD RD STE 2
Practice Address - Street 2:
Practice Address - City:DEATSVILLE
Practice Address - State:AL
Practice Address - Zip Code:36022-3800
Practice Address - Country:US
Practice Address - Phone:334-543-4269
Practice Address - Fax:334-543-4272
Is Sole Proprietor?:No
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH11959225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist