Provider Demographics
NPI:1346406048
Name:COOK, ERIC (MPT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:COOK
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7033 N FRESNO ST STE 202
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2976
Mailing Address - Country:US
Mailing Address - Phone:559-438-4300
Mailing Address - Fax:559-438-4300
Practice Address - Street 1:7033 N FRESNO ST STE 202
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2976
Practice Address - Country:US
Practice Address - Phone:559-438-4300
Practice Address - Fax:559-438-4300
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24888225100000X
CA248882251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT24888OtherCA PHYSICAL THERAPY LICENSE