| Doctor Name: | MR. ROY LEE COGGIN |
| NPI Number: | 1164628806 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CPED,COF |
| License Number: | |
| Business Practice Address: | 3708 N Main St. Farmville, NC - 278281434 |
| Business Phone Number: | 2527532092 |
| Business Fax Number: | 2527532499 |
| Mailing Address: | Po Box 690, FARMVILLE |
| State: | NC |
| Postal Code: | 278280690 |
| Phone Number: | 2527532092 |
| Fax Number: | 2527532499 |
| NPI Enumeration Date: | 06/21/2007 |
| NPI Last Update Date: | 11/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225000000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Orthotic Fitter |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the management of fitting prefabricated orthoses. |