Healthcare Provider Details

I. General information

NPI: 1427193697
Provider Name (Legal Business Name): COX CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 W MCNEESE ST
LAKE CHARLES LA
70605-5528
US

IV. Provider business mailing address

PO BOX 3084
LAKE CHARLES LA
70602-3084
US

V. Phone/Fax

Practice location:
  • Phone: 337-474-9400
  • Fax: 337-474-0640
Mailing address:
  • Phone: 337-436-7560
  • Fax: 337-433-9861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number859
License Number StateLA

VIII. Authorized Official

Name: DR. KEVIN COX
Title or Position: PRESIDENT
Credential: DC
Phone: 337-474-9400