MEDICARE: COX CHIROPRACTIC, INC.

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	111N00000X	Chiropractor	859	LA

General Provider Information

NPI Number	:	1427193697
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COX CHIROPRACTIC, INC.

Provider Business Mailing Address
First Line	:	PO BOX 3084
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70602-3084
Country	:	US
Telephone Number	:	337-436-7560
Fax Number	:	337-433-9861

Provider Business Practice Location Address
First Line	:	540 W MCNEESE ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-5528
Country	:	US
Telephone Number	:	337-474-9400
Fax Number	:	337-474-0640

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KEVIN COX
Credential	:	DC
Telephone Number	:	337-474-9400

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	08/22/2020

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