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General NPI Number Information
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NPI Number | 1285883645
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Entity Type | Individual
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Provider Name | AMANDA JEAN COOK PT, DPT PT25782
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Gender | Female
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Dates
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Enumeration Date | 09/10/2008
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Last Update Date | 04/26/2023
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Provider Practice Location Address
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Address Line | 3260 LAKE POINTE BLVD
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City | SARASOTA
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State | FL
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Zip | 34231-6896
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Country | US
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Telephone | 941-929-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 103 18TH ST NE
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City | BRADENTON
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State | FL
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Zip | 34208-1428
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Country | US
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Telephone | 941-243-5811
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 017096
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT25782
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License Number State | FL
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