Provider Demographics
NPI:1427148923
Name:COX, CHERYL ELAINE (PT)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ELAINE
Last Name:COX
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16930 MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:APPLEGATE
Mailing Address - State:CA
Mailing Address - Zip Code:95703-9740
Mailing Address - Country:US
Mailing Address - Phone:530-878-7438
Mailing Address - Fax:
Practice Address - Street 1:140 LITTON DR STE 110
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5078
Practice Address - Country:US
Practice Address - Phone:530-274-8720
Practice Address - Fax:530-273-0467
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9468225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PT94680Medicare ID - Type Unspecified