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General NPI Number Information
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NPI Number | 1932400819
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Entity Type | Organization
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Legal Business Name | DR. COOK'S EYE CARE CENTERS, INC.
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Dates
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Enumeration Date | 11/09/2010
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Last Update Date | 11/09/2010
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Provider Practice Location Address
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Address Line | 1485 COMMERCIAL WAY
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City | SPRING HILL
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State | FL
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Zip | 34606-4525
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Country | US
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Telephone | 573-219-0315
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2647
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City | TARPON SPRINGS
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State | FL
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Zip | 34688-2647
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Country | US
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Telephone | 573-219-0315
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRAD COOK
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Credential |
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Telephone | 573-219-0315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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