Provider Demographics
NPI:1114999273
Name:COOK, BARBARA SUE (DC)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:SUE
Last Name:COOK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 6TH AVE
Mailing Address - Street 2:P O BOX 132
Mailing Address - City:DAYTON
Mailing Address - State:KY
Mailing Address - Zip Code:41074-1143
Mailing Address - Country:US
Mailing Address - Phone:859-431-3624
Mailing Address - Fax:859-431-4024
Practice Address - Street 1:613 6TH AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:KY
Practice Address - Zip Code:41074-1143
Practice Address - Country:US
Practice Address - Phone:859-431-3624
Practice Address - Fax:859-431-4024
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3982111N00000X
OH1414111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6052101OtherMEDICARE PTAN
KY6052101OtherMEDICARE PTAN
KY6052101Medicare PIN