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NPI Code Detail

MEDICARE: COOK CHIROPRACTIC CLINIC

MEDICARE: COOK CHIROPRACTIC CLINIC
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
1111NN0400XNeurology Chiropractor002445GA

General Provider Information

NPI Number : 1902052624
Entity Type Code : Organization
Provider Name (Legal Business Name) : COOK CHIROPRACTIC CLINIC
Provider Business Mailing Address
First Line : PO BOX 433
Second Line :
City : TENNILLE
State : GA
Zip : 31089-0433
Country : US
Telephone Number : 478-552-2161
Fax Number : 478-552-3007
Provider Business Practice Location Address
First Line : 524 SPARTA RD
Second Line :
City : SANDERSVILLE
State : GA
Zip : 31082-1376
Country : US
Telephone Number : 478-552-2161
Fax Number : 478-552-3007
Authorized Official
Title or Position : OWNER
Name : DR. ROBERT DENNIS COOK
Credential : D.C.
Telephone Number : 478-552-2161
Provider Enumeration Date : 08/13/2008
Last Update Date : 08/13/2008

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Directions to “COOK CHIROPRACTIC CLINIC ” Practice Location

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