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NPI Code Detail

MEDICARE: KENDRA COOK

MEDICARE: KENDRA COOK
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
1225X00000XOccupational Therapist4107SC

General Provider Information

NPI Number : 1437614732
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDRA COOK
Provider Business Mailing Address
First Line : 201 W 9TH NORTH ST
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29483-6721
Country : US
Telephone Number : 843-879-0922
Fax Number :
Provider Business Practice Location Address
First Line : 201 W 9TH NORTH ST
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29483-6721
Country : US
Telephone Number : 843-879-0922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2019
Last Update Date : 01/31/2019

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Directions to “ KENDRA COOK ” Practice Location

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