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NPI Code Detail

MEDICARE: MS. REBECCA S COOK LDH

MEDICARE: MS. REBECCA S COOK LDH
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
1124Q00000XDental Hygienist13006497AIN

General Provider Information

NPI Number : 1740507748
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. REBECCA S COOK LDH
Provider Business Mailing Address
First Line : 1262 N COUNTY ROAD 425 E
Second Line :
City : AVON
State : IN
Zip : 46123-8669
Country : US
Telephone Number : 317-745-2999
Fax Number :
Provider Business Practice Location Address
First Line : 9443 E 38TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46235-2132
Country : US
Telephone Number : 317-890-2100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2010
Last Update Date : 04/29/2010

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Directions to “ MS. REBECCA S COOK LDH” Practice Location

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