Healthcare Provider Details

I. General information

NPI: 1578040481
Provider Name (Legal Business Name): KRISTEN ROSATO COOK PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 OAK VIEW DR
GODLEY TX
76044-3879
US

IV. Provider business mailing address

121 OAK VIEW DR
GODLEY TX
76044-3879
US

V. Phone/Fax

Practice location:
  • Phone: 806-438-1606
  • Fax:
Mailing address:
  • Phone: 806-438-1606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1192733
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: