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Individual

MR. ROY LEE COGGIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPED,COF

Contact information

Practice address
3708 N MAIN ST., FARMVILLE, NC 27828-1434
(252) 753-2092
(252) 753-2499
Mailing address
PO BOX 690, FARMVILLE, NC 27828-0690
(252) 753-2092
(252) 753-2499

Taxonomy

Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
NC
225000000X
Orthotic Fitter

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7795254
NC
05
7795300
NC
Enumeration date
06/21/2007
Last updated
11/15/2012
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