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NPI Code Detail

MEDICARE: MYRIAM ELIZABETH COKER PT, DPT

MEDICARE: MYRIAM ELIZABETH COKER PT, DPT
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
1225100000XPhysical Therapist13670TN

General Provider Information

NPI Number : 1811665946
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYRIAM ELIZABETH COKER PT, DPT
Provider Business Mailing Address
First Line : 1624 WILLEY ST
Second Line :
City : MEMPHIS
State : TN
Zip : 38119-6961
Country : US
Telephone Number : 662-397-1417
Fax Number :
Provider Business Practice Location Address
First Line : 1314 PEABODY AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-3500
Country : US
Telephone Number : 901-321-5803
Fax Number : 901-405-0250
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2021
Last Update Date : 04/07/2023

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