Healthcare Provider Details

I. General information

NPI: 1114999273
Provider Name (Legal Business Name): BARBARA SUE COOK D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 05/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 6TH AVE
DAYTON KY
41074-1143
US

IV. Provider business mailing address

613 6TH AVE P O BOX 132
DAYTON KY
41074-1143
US

V. Phone/Fax

Practice location:
  • Phone: 859-431-3624
  • Fax: 859-431-4024
Mailing address:
  • Phone: 859-431-3624
  • Fax: 859-431-4024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3982
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1414
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: