MEDICARE: WILLIAM ALEXANDER COLE

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	2305211820	VA

General Provider Information

NPI Number	:	1629575998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM ALEXANDER COLE

Provider Business Mailing Address
First Line	:	710 HARPOLD AVE
Second Line	:
City	:	RAVENSWOOD
State	:	WV
Zip	:	26164-1340
Country	:	US
Telephone Number	:	304-532-3914
Fax Number	:

Provider Business Practice Location Address
First Line	:	74 MIZPAH RD
Second Line	:
City	:	LOCUST HILL
State	:	VA
Zip	:	23092-9808
Country	:	US
Telephone Number	:	804-758-5260
Fax Number	:

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

Provider Enumeration Date	:	04/12/2018
Last Update Date	:	04/12/2018

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Directions to “ WILLIAM ALEXANDER COLE ” Practice Location

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