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General NPI Number Information
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NPI Number | 1457114902
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Entity Type | Individual
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Provider Name | LYSIA ROSE COOK DPT
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Gender | Female
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Dates
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Enumeration Date | 02/06/2024
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 4160 LITTLE YORK RD STE 10
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City | DAYTON
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State | OH
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Zip | 45414-5803
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Country | US
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Telephone | 937-415-9100
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Fax | 937-415-9191
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Provider Business Mailing Address
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Address Line | 6551 CENTERVILLE BUSINESS PKWY STE 120
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City | CENTERVILLE
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State | OH
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Zip | 45459-2696
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Country | US
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Telephone | 937-415-9100
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Fax | 937-415-9191
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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 | CP048601T
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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 | PT032024
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License Number State | PA
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