MEDICARE: CAROL E. COOK-PISCOPO RPT

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	1212	NH

General Provider Information

NPI Number	:	1750428330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL E. COOK-PISCOPO RPT

Provider Business Mailing Address
First Line	:	11 KIMBALL DR
Second Line	:	SUITE 128
City	:	HOOKSETT
State	:	NH
Zip	:	03106-2603
Country	:	US
Telephone Number	:	603-836-4464
Fax Number	:	603-836-4501

Provider Business Practice Location Address
First Line	:	11 KIMBALL DR
Second Line	:	SUITE 128
City	:	HOOKSETT
State	:	NH
Zip	:	03106-2603
Country	:	US
Telephone Number	:	603-836-4464
Fax Number	:	603-836-4501

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

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	06/26/2008

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