MEDICARE: SUSAN P COX PT

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	005606	CT
2	225100000X	Physical Therapist	8507	NC

General Provider Information

NPI Number	:	1154492288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN P COX PT

Provider Business Mailing Address
First Line	:	1020 WOOD POPPY ST
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-3887
Country	:	US
Telephone Number	:	203-305-3987
Fax Number	:

Provider Business Practice Location Address
First Line	:	2115 S MAIN ST STE C
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-5011
Country	:	US
Telephone Number	:	919-570-5755
Fax Number	:

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

Provider Enumeration Date	:	11/12/2006
Last Update Date	:	04/28/2010

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Directions to “ SUSAN P COX PT” Practice Location

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