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General NPI Number Information
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NPI Number | 1801165642
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Entity Type | Organization
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Legal Business Name | COX PHYSICAL THERAPY
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Dates
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Enumeration Date | 12/23/2011
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Last Update Date | 11/04/2015
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Provider Practice Location Address
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Address Line | 2900 BRISTOL ST J107
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City | COSTA MESA
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State | CA
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Zip | 92626-5981
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Country | US
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Telephone | 949-226-9681
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Fax | 949-627-8081
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Provider Business Mailing Address
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Address Line | 1939 CONTINENTAL AVE
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City | COSTA MESA
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State | CA
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Zip | 92627-4125
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Country | US
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Telephone | 949-226-9681
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARY ELIZABETH COX
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Credential | PT
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Telephone | 949-226-9681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT18971
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License Number State | CA
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