MEDICARE: JENNY COX OTA/L

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	224Z00000X	Occupational Therapy Assistant	534	OK

General Provider Information

NPI Number	:	1548651557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNY COX OTA/L

Provider Business Mailing Address
First Line	:	7601 LEOMA LN
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73150-4229
Country	:	US
Telephone Number	:	405-596-1896
Fax Number	:

Provider Business Practice Location Address
First Line	:	7601 LEOMA LN
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73150-4229
Country	:	US
Telephone Number	:	405-596-1896
Fax Number	:

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

Provider Enumeration Date	:	02/12/2015
Last Update Date	:	02/12/2015

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