Provider Demographics
NPI:1366031825
Name:COOK, KRISTEN (DC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
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 1:2121 S GERMANTOWN RD STE 4
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3861
Mailing Address - Country:US
Mailing Address - Phone:901-757-9000
Mailing Address - Fax:901-755-9605
Practice Address - Street 1:2121 S GERMANTOWN RD STE 4
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3861
Practice Address - Country:US
Practice Address - Phone:901-757-9000
Practice Address - Fax:901-755-9605
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3381111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor