Provider Demographics
NPI:1275303513
Name:COXWORTH, SYDNEY (DC)
Entity Type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:
Last Name:COXWORTH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1929 SOUTHCROSS DR W APT 1207
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-7945
Mailing Address - Country:US
Mailing Address - Phone:507-236-4218
Mailing Address - Fax:
Practice Address - Street 1:832 CARMICHAEL RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-7759
Practice Address - Country:US
Practice Address - Phone:715-924-6295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6157-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor