Provider Demographics
NPI:1821560731
Name:COX, MICHAELA LYNN (LMT)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:LYNN
Last Name:COX
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15200 E GIRARD AVE STE 3500
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-5004
Mailing Address - Country:US
Mailing Address - Phone:720-277-9715
Mailing Address - Fax:
Practice Address - Street 1:15200 E GIRARD AVE STE 3500
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-5004
Practice Address - Country:US
Practice Address - Phone:720-277-9715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0015394225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO016777211290WC01GBOtherONE CALL CARE