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General NPI Number Information
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NPI Number | 1942518568
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Entity Type | Organization
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Legal Business Name | BARRY P COOK OD PC
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Dates
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Enumeration Date | 09/16/2010
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Last Update Date | 09/16/2010
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Provider Practice Location Address
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Address Line | 92 N 400 E
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City | PRICE
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State | UT
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Zip | 84501-2509
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Country | US
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Telephone | 435-637-6290
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Fax | 435-637-6291
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Provider Business Mailing Address
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Address Line | 92 N 400 E
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City | PRICE
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State | UT
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Zip | 84501-2509
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Country | US
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Telephone | 435-637-6290
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Fax | 435-637-6291
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Authorized Official
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Title or Position | OPTOMETRIC PHYSICIAN
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Name | DR. BARRY PAUL COOK
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Credential | OD
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Telephone | 435-637-6290
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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 | U0328
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License Number State | UT
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