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Individual
MARY FOX
Active
Individual
MARY FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, OCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT30980
FL
2251X0800X
Orthopedic Physical Therapist
30980
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016402200
—
FL
01
—
RWEG2
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/17/2015
Last updated
02/26/2018
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