Healthcare Provider Details
I. General information
NPI: 1326295460
Provider Name (Legal Business Name): MEGAN COX GONZALEZ DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/20/2008
Last Update Date: 04/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1701 LIBRARY BLVD SUITE A
GREENWOOD IN
46142
US
IV. Provider business mailing address
1701 LIBRARY BLVD SUITE A COLLABORATING FOR KIDS, LLC
GREENWOOD IN
46142
US
V. Phone/Fax
- Phone: 317-881-9923
- Fax: 614-840-9310
- Phone: 614-840-0558
- Fax: 614-840-9310
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251P0200X |
| Taxonomy | Pediatric Physical Therapist |
| License Number | PT 012145 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: