Provider Demographics
NPI:1043752561
Name:COX, ANNIE E (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ANNIE
Middle Name:E
Last Name:COX
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:E
Other - Last Name:BATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 GREYSON CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-1740
Mailing Address - Country:US
Mailing Address - Phone:916-622-0568
Mailing Address - Fax:
Practice Address - Street 1:4101 RAEFORD RD UNIT 100B
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4126
Practice Address - Country:US
Practice Address - Phone:910-488-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT292444225100000X
225100000X
NCP18280225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist