Provider Demographics
NPI:1740772680
Name:COX, ROBERT W (DAT LAT ATC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:COX
Suffix:
Gender:M
Credentials:DAT LAT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 140
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN GREEN
Mailing Address - State:UT
Mailing Address - Zip Code:84632-0140
Mailing Address - Country:US
Mailing Address - Phone:801-885-9978
Mailing Address - Fax:
Practice Address - Street 1:445 N STATE ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN GREEN
Practice Address - State:UT
Practice Address - Zip Code:84632
Practice Address - Country:US
Practice Address - Phone:801-885-9978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8465749-48102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer