Provider Demographics
NPI:1972123784
Name:COX, MINDI ELAINE (LMT,MMT)
Entity Type:Individual
Prefix:MRS
First Name:MINDI
Middle Name:ELAINE
Last Name:COX
Suffix:
Gender:F
Credentials:LMT,MMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2347 OLD SMITHVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74957-5544
Mailing Address - Country:US
Mailing Address - Phone:580-703-3209
Mailing Address - Fax:
Practice Address - Street 1:2347 OLD SMITHVILLE HWY
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:OK
Practice Address - Zip Code:74957-5544
Practice Address - Country:US
Practice Address - Phone:580-703-3209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK826117208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation