Provider Demographics
NPI:1467877639
Name:COOK, TOMEKA (DPT)
Entity Type:Individual
Prefix:
First Name:TOMEKA
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 MONTAGUE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-5953
Mailing Address - Country:US
Mailing Address - Phone:360-632-9896
Mailing Address - Fax:
Practice Address - Street 1:210 SE PIONEER WAY
Practice Address - Street 2:SUITE 2
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-5704
Practice Address - Country:US
Practice Address - Phone:360-679-8600
Practice Address - Fax:360-679-8554
Is Sole Proprietor?:No
Enumeration Date:2014-02-25
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT34713225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist