Provider Demographics
NPI:1740596881
Name:COTTON, PHYLLIS CARTER (PT)
Entity Type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:CARTER
Last Name:COTTON
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 1:7527 CATONE CT
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-1760
Mailing Address - Country:US
Mailing Address - Phone:301-567-7018
Mailing Address - Fax:301-567-5662
Practice Address - Street 1:7527 CATONE CT
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-1760
Practice Address - Country:US
Practice Address - Phone:301-567-7018
Practice Address - Fax:301-567-5662
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14996225100000X
DC430225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist