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General NPI Number Information
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NPI Number | 1316295157
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Entity Type | Organization
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Legal Business Name | HYPERBARIC MEDICINE GROUP, INC
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Dates
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Enumeration Date | 08/28/2012
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Last Update Date | 08/28/2012
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Provider Practice Location Address
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Address Line | 4100 SION FARM COMMERCIAL CENTER SUITE 8
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City | CHRISTIANSTED
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State | VI
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Zip | 00820-4433
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Country | US
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Telephone | 340-713-8400
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Fax | 340-713-7280
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Provider Business Mailing Address
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Address Line | 4100 SION FARM COMMERCIAL CENTER
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City | CHRISTIANSTED
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State | VI
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Zip | 00820-4433
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Country | US
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Telephone | 340-713-8400
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Fax | 340-713-7280
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IAN KEITH COOK
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Credential | D.P.M.
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Telephone | 340-713-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 2192291L
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License Number State | VI
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