Provider Demographics
NPI:1174581672
Name:COX, CAROL MARIE (DPT)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:MARIE
Last Name:COX
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:MARIE
Other - Last Name:KEMMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:6346 THORNBERRY CT
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-7729
Mailing Address - Country:US
Mailing Address - Phone:513-545-7192
Mailing Address - Fax:
Practice Address - Street 1:7109A HAMILTON MASON RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-1784
Practice Address - Country:US
Practice Address - Phone:513-759-6494
Practice Address - Fax:513-759-6672
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012702225100000X
OH011662225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH108341Medicaid
OH108341Medicaid