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General NPI Number Information
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NPI Number | 1609383504
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Entity Type | Individual
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Provider Name | FAITH COOK MA
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Gender | Female
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Dates
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Enumeration Date | 01/02/2018
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Last Update Date | 01/02/2018
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Provider Practice Location Address
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Address Line | 1411 QUEEN ANN ST
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City | BURLINGTON
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State | NC
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Zip | 27217-7464
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Country | US
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Telephone | 804-356-4744
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Fax | 866-355-8910
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Provider Business Mailing Address
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Address Line | 1411 QUEEN ANN ST
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City | BURLINGTON
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State | NC
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Zip | 27217-7464
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Country | US
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Telephone | 804-356-4744
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Fax | 866-355-8910
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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