Provider Demographics
NPI:1942525506
Name:COX, JOLENE RUTH (CMT)
Entity Type:Individual
Prefix:
First Name:JOLENE
Middle Name:RUTH
Last Name:COX
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4821 LANSING AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-8241
Mailing Address - Country:US
Mailing Address - Phone:517-812-0230
Mailing Address - Fax:
Practice Address - Street 1:123 PALMER ST
Practice Address - Street 2:
Practice Address - City:RIVES JUNCTION
Practice Address - State:MI
Practice Address - Zip Code:49277-9749
Practice Address - Country:US
Practice Address - Phone:517-569-2467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist