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NPI Code Detail

MEDICARE: MARY CRISS COCKS OTR/L

MEDICARE:   MARY CRISS COCKS  OTR/L
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
1172V00000XCommunity Health WorkerOT10614FL

General Provider Information

NPI Number : 1952615536
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY CRISS COCKS OTR/L
Provider Business Mailing Address
First Line : 3443 MERRICK LN
Second Line :
City : MARGATE
State : FL
Zip : 33063-8245
Country : US
Telephone Number : 561-504-8831
Fax Number :
Provider Business Practice Location Address
First Line : 3443 MERRICK LN
Second Line :
City : MARGATE
State : FL
Zip : 33063-8245
Country : US
Telephone Number : 561-504-8831
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2010
Last Update Date : 08/05/2010

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Directions to “ MARY CRISS COCKS OTR/L” Practice Location

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