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NPI Code Detail

MEDICARE: JESSICA LYNN COX PTA

MEDICARE: JESSICA LYNN COX PTA
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
1225200000XPhysical Therapy AssistantP160039504WA

General Provider Information

NPI Number : 1184154015
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA LYNN COX PTA
Provider Business Mailing Address
First Line : 151 BUENA VISTA DR
Second Line :
City : COLVILLE
State : WA
Zip : 99114-8676
Country : US
Telephone Number : 509-864-4935
Fax Number :
Provider Business Practice Location Address
First Line : 151 BUENA VISTA DR
Second Line :
City : COLVILLE
State : WA
Zip : 99114-8676
Country : US
Telephone Number : 509-684-4539
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2017
Last Update Date : 06/13/2017

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