Provider Demographics
NPI:1326529967
Name:COOK, MEGAN (DC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
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 1:22000 DULLES RETAIL PLZ STE 108
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-2515
Mailing Address - Country:US
Mailing Address - Phone:703-936-7014
Mailing Address - Fax:
Practice Address - Street 1:22000 DULLES RETAIL PLZ STE 108
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-2515
Practice Address - Country:US
Practice Address - Phone:703-936-7014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03985111N00000X
VA0104557558111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor