MEDICARE: MRS. CARMEN COOPER OGUZ 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	PT2342	MS

General Provider Information

NPI Number	:	1649490426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARMEN COOPER OGUZ PT

Provider Business Mailing Address
First Line	:	305 SHUMATE CIR
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-2215
Country	:	US
Telephone Number	:	662-756-2711
Fax Number	:	662-756-4021

Provider Business Practice Location Address
First Line	:	305 SHUMATE CIR
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-2215
Country	:	US
Telephone Number	:	662-402-8887
Fax Number	:

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

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	07/08/2007

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