Provider Demographics
NPI:1386010767
Name:COOK, KATHLEEN JOSEF (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:JOSEF
Last Name:COOK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:MARIE
Other - Last Name:JOSEF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 E. CLEVELAND AVE.
Mailing Address - Street 2:
Mailing Address - City:MONETT
Mailing Address - State:MO
Mailing Address - Zip Code:65708
Mailing Address - Country:US
Mailing Address - Phone:417-236-2480
Mailing Address - Fax:417-236-2481
Practice Address - Street 1:700 E. CLEVELAND AVE.
Practice Address - Street 2:
Practice Address - City:MONETT
Practice Address - State:MO
Practice Address - Zip Code:65708
Practice Address - Country:US
Practice Address - Phone:417-236-2480
Practice Address - Fax:417-236-2481
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4258225100000X
OK5234225100000X
MO2015027110225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist