Provider Demographics
NPI:1295814606
Name:COX, JANE M (PT)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:M
Last Name:COX
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2860 E BANTA RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-4916
Mailing Address - Country:US
Mailing Address - Phone:317-709-8707
Mailing Address - Fax:253-736-1712
Practice Address - Street 1:2860 E BANTA RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-4916
Practice Address - Country:US
Practice Address - Phone:317-709-8707
Practice Address - Fax:253-736-1712
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05001382225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist