Provider Demographics
NPI:1710191648
Name:COX, LAURA (MOTRL)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:MOTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 W CHARLESTON BLVD
Mailing Address - Street 2:APT. 111
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-1006
Mailing Address - Country:US
Mailing Address - Phone:702-437-0294
Mailing Address - Fax:
Practice Address - Street 1:2625 E SAINT LOUIS AVE
Practice Address - Street 2:SEIGLE DIAGNOSTIC CENTER
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-4200
Practice Address - Country:US
Practice Address - Phone:702-855-6903
Practice Address - Fax:702-799-1502
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0555225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist