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NPI Code Detail

MEDICARE: BRYCE COOK

MEDICARE: BRYCE COOK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1154162105
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYCE COOK
Provider Business Mailing Address
First Line : 2903 W 24TH ST
Second Line :
City : KEARNEY
State : NE
Zip : 68845-4925
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2722 S LOCUST ST
Second Line :
City : GRAND ISLAND
State : NE
Zip : 68801-8230
Country : US
Telephone Number : 308-455-9411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2024
Last Update Date : 08/05/2024

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Directions to “ BRYCE COOK ” Practice Location

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