Provider Demographics
NPI:1023548864
Name:COOK, AMBER (DPT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:SUHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:950 NORWOOD DR SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-3426
Mailing Address - Country:US
Mailing Address - Phone:319-939-3742
Mailing Address - Fax:
Practice Address - Street 1:502 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:IA
Practice Address - Zip Code:52349-2254
Practice Address - Country:US
Practice Address - Phone:319-472-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA087650225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist