Provider Demographics
NPI:1982864351
Name:COX, GEORGE THOMAS III (PT)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:THOMAS
Last Name:COX
Suffix:III
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:1878 W SHEEP HILL CT
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-5956
Mailing Address - Country:US
Mailing Address - Phone:208-403-3415
Mailing Address - Fax:208-454-6388
Practice Address - Street 1:2814 S INDIANA AVE
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-5925
Practice Address - Country:US
Practice Address - Phone:208-454-0380
Practice Address - Fax:208-454-6388
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDPT 254225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist