Healthcare Provider Details

I. General information

NPI: 1861065492
Provider Name (Legal Business Name): JULIA BORLAND COOK PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH STREET BA 3676 - REHAB SERVICES
AUGUSTA GA
30912
US

IV. Provider business mailing address

550 HILLWOOD CIR
AUGUSTA GA
30909-3320
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-2396
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT011992
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: