Provider Demographics
NPI:1649497512
Name:COTTON, LANCE MICHAEL (PT, DPT)
Entity type:Individual
Prefix:MR
First Name:LANCE
Middle Name:MICHAEL
Last Name:COTTON
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4726 ROYAL COURT CIR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-3229
Mailing Address - Country:US
Mailing Address - Phone:325-665-6804
Mailing Address - Fax:
Practice Address - Street 1:4726 ROYAL COURT CIR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-3229
Practice Address - Country:US
Practice Address - Phone:325-665-6804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1143998225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist