Provider Demographics
NPI:1720802374
Name:COX, CAROLINE VICTORIA (PT, DPT)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:VICTORIA
Last Name:COX
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 EAGLE BEND LN
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37716-3807
Mailing Address - Country:US
Mailing Address - Phone:706-508-5005
Mailing Address - Fax:
Practice Address - Street 1:4905 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-2315
Practice Address - Country:US
Practice Address - Phone:865-689-8299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15927225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist