MEDICARE: DR. JANET LEANNE COBB PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT2778	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235564600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANET LEANNE COBB PT, DPT

Provider Business Mailing Address
First Line	:	12627 VINEY GROVE RD
Second Line	:
City	:	PRAIRIE GROVE
State	:	AR
Zip	:	72753-8251
Country	:	US
Telephone Number	:	479-790-7845
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 SOUTHWINDS RD STE 7
Second Line	:
City	:	FARMINGTON
State	:	AR
Zip	:	72730-8652
Country	:	US
Telephone Number	:	479-267-2777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2013
Last Update Date	:	03/29/2018

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