MEDICARE: HALLEY PORTER 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	10816	AL

General Provider Information

NPI Number	:	1154191286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALLEY PORTER COX

Provider Business Mailing Address
First Line	:	617 AYDEN MANNON ST
Second Line	:
City	:	ROGERSVILLE
State	:	AL
Zip	:	35652-5226
Country	:	US
Telephone Number	:	256-320-8023
Fax Number	:

Provider Business Practice Location Address
First Line	:	618 E TENNESSEE ST
Second Line	:
City	:	FLORENCE
State	:	AL
Zip	:	35630-5806
Country	:	US
Telephone Number	:	256-320-8023
Fax Number	:

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

Provider Enumeration Date	:	01/09/2024
Last Update Date	:	01/09/2024

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Directions to “ HALLEY PORTER COX ” Practice Location

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