Provider Demographics
NPI:1336939941
Name:SVEDIN, CODY G
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:G
Last Name:SVEDIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7833 S ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:MELBA
Mailing Address - State:ID
Mailing Address - Zip Code:83641-6035
Mailing Address - Country:US
Mailing Address - Phone:208-989-6049
Mailing Address - Fax:
Practice Address - Street 1:5251 E EXCHANGE WAY
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-5507
Practice Address - Country:US
Practice Address - Phone:208-466-9642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist