Healthcare Provider Details

I. General information

NPI: 1083530737
Provider Name (Legal Business Name): ABBEY MARIE COOK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 N WASHINGTON AVE
MADISON SD
57042-1735
US

IV. Provider business mailing address

515 SW 2ND ST
MADISON SD
57042-2716
US

V. Phone/Fax

Practice location:
  • Phone: 605-256-5229
  • Fax:
Mailing address:
  • Phone: 815-257-2379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number0720
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: