MEDICARE: DR. JERIMY TODD COX D.C.

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	3829	OK

General Provider Information

NPI Number	:	1437285970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERIMY TODD COX D.C.

Provider Business Mailing Address
First Line	:	401 N OLYMPIA ST
Second Line	:
City	:	PONCA CITY
State	:	OK
Zip	:	74601-3624
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1043 N UNION ST
Second Line	:
City	:	PONCA CITY
State	:	OK
Zip	:	74601-2556
Country	:	US
Telephone Number	:	580-762-1500
Fax Number	:

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	07/08/2007

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