Provider Demographics
NPI:1275390510
Name:COOK, ANDREW CHRISTIAN
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:CHRISTIAN
Last Name:COOK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 W STREETSBORO ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-2054
Mailing Address - Country:US
Mailing Address - Phone:330-903-4990
Mailing Address - Fax:
Practice Address - Street 1:657 W STREETSBORO ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-2054
Practice Address - Country:US
Practice Address - Phone:330-903-4990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program