Provider Demographics
NPI:1124258793
Name:FOX, JOAN M (PT)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:FOX
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:152 GAIL ANN DR
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-9327
Mailing Address - Country:US
Mailing Address - Phone:419-447-7203
Mailing Address - Fax:419-447-5577
Practice Address - Street 1:1717 E CHICAGO ROAD
Practice Address - Street 2:STURGIS HOSPITAL
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091
Practice Address - Country:US
Practice Address - Phone:269-659-4468
Practice Address - Fax:269-659-2744
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5501001553225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist