Provider Demographics
NPI:1841367083
Name:COX, LINDA C (PT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:C
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 1:411 CENTRAL AVE
Mailing Address - Street 2:STE 4
Mailing Address - City:SOUTH WILLIAMSON
Mailing Address - State:KY
Mailing Address - Zip Code:41503-4149
Mailing Address - Country:US
Mailing Address - Phone:606-237-0004
Mailing Address - Fax:606-237-0330
Practice Address - Street 1:411 CENTRAL AVE
Practice Address - Street 2:STE 4
Practice Address - City:SOUTH WILLIAMSON
Practice Address - State:KY
Practice Address - Zip Code:41503-4149
Practice Address - Country:US
Practice Address - Phone:606-237-0004
Practice Address - Fax:606-237-0330
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1004225100000X
KY003253225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0158219000Medicaid
KY000000279222OtherANTHEM BC BS
KY000000279222OtherANTHEM BC BS
KYS88899Medicare UPIN