Individual
MR. RAY SCOTT COCKROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
130 PARKWAY PLAZA, KOSCIUSKO, MS 39090
(662) 289-3588
(662) 289-3533
Mailing address
PO BOX 23996, JACKSON, MS 39225
(601) 206-6100
(601) 206-6024
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT224
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02224508
—
MS
Enumeration date
04/13/2006
Last updated
12/12/2012
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