Provider Demographics
NPI:1386034676
Name:COX CHIROPRACTIC
Entity type:Organization
Organization Name:COX CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:863-253-1853
Mailing Address - Street 1:625 SW JACOBY AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-3954
Mailing Address - Country:US
Mailing Address - Phone:863-253-1853
Mailing Address - Fax:
Practice Address - Street 1:625 SW JACOBY AVE
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-3954
Practice Address - Country:US
Practice Address - Phone:863-253-1853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty