Healthcare Provider Details

I. General information

NPI: 1932011202
Provider Name (Legal Business Name): TRAVIS JAMES COOK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

574 CUMMINGS ST STE 8-9
ABINGDON VA
24210-3240
US

IV. Provider business mailing address

18343 WESTWOOD DR
ABINGDON VA
24211-6927
US

V. Phone/Fax

Practice location:
  • Phone: 540-527-3830
  • Fax:
Mailing address:
  • Phone: 304-890-6739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: