Provider Demographics
NPI:1386854040
Name:COX, DODD MITCHELL (ATC)
Entity Type:Individual
Prefix:MR
First Name:DODD
Middle Name:MITCHELL
Last Name:COX
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4181 NORSEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-2254
Mailing Address - Country:US
Mailing Address - Phone:308-379-7467
Mailing Address - Fax:
Practice Address - Street 1:620 N. DIERS AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-5285
Practice Address - Country:US
Practice Address - Phone:308-382-0344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE412255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer