MEDICARE: JOE T HOOK CSCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	7247870905	CO

General Provider Information

NPI Number	:	1164851721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOE T HOOK CSCS

Provider Business Mailing Address
First Line	:	4055 COMMERCIAL BLVD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-2146
Country	:	US
Telephone Number	:	513-843-5909
Fax Number	:	513-272-8828

Provider Business Practice Location Address
First Line	:	4055 COMMERCIAL BLVD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-2146
Country	:	US
Telephone Number	:	513-843-5909
Fax Number	:	513-272-8828

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2013
Last Update Date	:	11/04/2013

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