Healthcare Provider Details

I. General information

NPI: 1508905613
Provider Name (Legal Business Name): DEBRA K COOKE MS, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 VAN VOORHIS RD STE 1
MORGANTOWN WV
26505-3530
US

IV. Provider business mailing address

486 BLACKBERRY RIDGE DR
MORGANTOWN WV
26508-4869
US

V. Phone/Fax

Practice location:
  • Phone: 304-685-0617
  • Fax: 304-566-1152
Mailing address:
  • Phone: 304-598-2212
  • Fax: 304-598-2258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number001082
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: