MEDICARE: MRS. MICHELLE THERESA COX PTA

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	225200000X	Physical Therapy Assistant	A2858	MD

General Provider Information

NPI Number	:	1932419744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE THERESA COX PTA

Provider Business Mailing Address
First Line	:	1910 HILLCREST RD
Second Line	:
City	:	WOODLAWN
State	:	MD
Zip	:	21207-5264
Country	:	US
Telephone Number	:	410-298-7545
Fax Number	:

Provider Business Practice Location Address
First Line	:	1910 HILLCREST RD
Second Line	:
City	:	WOODLAWN
State	:	MD
Zip	:	21207
Country	:	US
Telephone Number	:	410-298-7545
Fax Number	:

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

Provider Enumeration Date	:	10/14/2010
Last Update Date	:	10/14/2010

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