Provider Demographics
NPI:1952899148
Name:COOKSEY, FELICIA (DPT)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:COOKSEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:
Other - Last Name:CLEMENTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:402 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:VA
Mailing Address - Zip Code:22812-1511
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34 W VIRGINIA WAY STE 1
Practice Address - Street 2:
Practice Address - City:RANSON
Practice Address - State:WV
Practice Address - Zip Code:25438-4882
Practice Address - Country:US
Practice Address - Phone:304-728-9090
Practice Address - Fax:304-728-9087
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-24
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
WVPT004784225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer