Provider Demographics
NPI:1073885927
Name:COX, GINGER A (LMT, CLT)
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:A
Last Name:COX
Suffix:
Gender:F
Credentials:LMT, CLT
Other - Prefix:MRS
Other - First Name:GINGER
Other - Middle Name:A
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT,CLT
Mailing Address - Street 1:1221 LUCIE AVENUE
Mailing Address - Street 2:121 LUCIE AVENUE
Mailing Address - City:DE LAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-3918
Mailing Address - Country:US
Mailing Address - Phone:386-785-6068
Mailing Address - Fax:386-736-6684
Practice Address - Street 1:112 W NEW YORK AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-5451
Practice Address - Country:US
Practice Address - Phone:386-785-6068
Practice Address - Fax:386-736-6684
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14516225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist