Provider Demographics
NPI:1811696800
Name:COX, ANDREW GUILLE (DC)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:GUILLE
Last Name:COX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7810 MARBLEHEAD CT
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-9367
Mailing Address - Country:US
Mailing Address - Phone:812-870-0561
Mailing Address - Fax:
Practice Address - Street 1:7810 MARBLEHEAD CT
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-9367
Practice Address - Country:US
Practice Address - Phone:812-870-0561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003365A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor