Provider Demographics
NPI:1407872435
Name:COOK, LANA BRANUM (DC)
Entity Type:Individual
Prefix:DR
First Name:LANA
Middle Name:BRANUM
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 1:109 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355
Mailing Address - Country:US
Mailing Address - Phone:931-728-9313
Mailing Address - Fax:931-728-9354
Practice Address - Street 1:109 E HIGH ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355
Practice Address - Country:US
Practice Address - Phone:931-728-9313
Practice Address - Fax:931-728-9354
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC1161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNBCBSTNOtherCOMMERCIAL
TN3678822Medicaid
TNBCBSTNOtherCOMMERCIAL
U65867Medicare UPIN