Provider Demographics
NPI:1134478233
Name:COX, DANIELLE ELIZABETH (PT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ELIZABETH
Last Name:COX
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:ELIZABETH
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 S MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:OK
Mailing Address - Zip Code:73030-1749
Mailing Address - Country:US
Mailing Address - Phone:580-369-3900
Mailing Address - Fax:580-369-3901
Practice Address - Street 1:201 S MAIN STREET
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:OK
Practice Address - Zip Code:73030-1749
Practice Address - Country:US
Practice Address - Phone:580-369-3900
Practice Address - Fax:580-369-3901
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4565225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist