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Individual

LAURA TIPTON COCKRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
436 S MAIN ST, STANTON, KY 40380
(606) 663-8244
(606) 663-8284
Mailing address
PO BOX 455, STANTON, KY 40380
(606) 663-8244
(606) 663-8284

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004520
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8700160800
KY
Enumeration date
08/03/2006
Last updated
03/10/2011
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