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NPI Code Detail

MEDICARE: KATELYN LEIGH COOK PT

MEDICARE: KATELYN LEIGH COOK PT
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
1225100000XPhysical TherapistPT24722ZZ

General Provider Information

NPI Number : 1184857682
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN LEIGH COOK PT
Provider Business Mailing Address
First Line : 7448 WILLOW GROVE PL
Second Line :
City : DAVIE
State : FL
Zip : 33314-4118
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1 OAKWOOD BLVD STE 130
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33020-1937
Country : US
Telephone Number : 954-925-3844
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2009
Last Update Date : 08/31/2009

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Directions to “ KATELYN LEIGH COOK PT” Practice Location

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