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NPI Code Detail

MEDICARE: WILLIAM COOK LMT

MEDICARE: WILLIAM COOK LMT
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
1225700000XMassage Therapist26898AZ

General Provider Information

NPI Number : 1396344099
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM COOK LMT
Provider Business Mailing Address
First Line : 6750 E SPEEDWAY BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85710-1220
Country : US
Telephone Number : 520-365-6939
Fax Number :
Provider Business Practice Location Address
First Line : 6750 E SPEEDWAY BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85710-1220
Country : US
Telephone Number : 520-365-6939
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2020
Last Update Date : 10/22/2020

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Directions to “ WILLIAM COOK LMT” Practice Location

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