Doctor Name: | OCTAVIA R COCKRELL |
NPI Number: | 1801022611 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 4064 |
Business Practice Address: | 2334 Se Washington Blvd Suite B & D Bartlesville, OK - 740067256 |
Business Phone Number: | 9183319184 |
Business Fax Number: | 9183319187 |
Mailing Address: | 10100 Forest Hills Rd, MACHESNEY PARK |
State: | IL |
Postal Code: | 611158234 |
Phone Number: | 8157132738 |
Fax Number: | 8152828597 |
NPI Enumeration Date: | 06/08/2009 |
NPI Last Update Date: | 06/08/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 4064 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |