MEDICARE: PHILLIP COX

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	225100000X	Physical Therapist	40QA01378800	NJ

General Provider Information

NPI Number	:	1083915979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILLIP COX

Provider Business Mailing Address
First Line	:	201 7TH ST
Second Line	:
City	:	RIVERTON
State	:	NJ
Zip	:	08077-1405
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3718 CHURCH RD
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-1104
Country	:	US
Telephone Number	:	856-235-7100
Fax Number	:

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

Provider Enumeration Date	:	11/08/2010
Last Update Date	:	11/08/2010

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Directions to “ PHILLIP COX ” Practice Location

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