MEDICARE: MR. PATRICK KENT COOK M.P.T.

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	225100000X	Physical Therapist	07259	LA

General Provider Information

NPI Number	:	1255525564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PATRICK KENT COOK M.P.T.

Provider Business Mailing Address
First Line	:	7648 PICARDY AVE
Second Line	:	SUITE 300
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4335
Country	:	US
Telephone Number	:	225-768-7676
Fax Number	:	225-768-7373

Provider Business Practice Location Address
First Line	:	7648 PICARDY AVE
Second Line	:	SUITE 300
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4335
Country	:	US
Telephone Number	:	225-768-7676
Fax Number	:	225-768-7373

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

Provider Enumeration Date	:	08/29/2007
Last Update Date	:	09/07/2007

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