Provider Demographics
NPI:1477164010
Name:COOK, SHAUN
Entity Type:Individual
Prefix:
First Name:SHAUN
Middle Name:
Last Name:COOK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 COLUMBIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ARMSTRONG
Mailing Address - State:IA
Mailing Address - Zip Code:50514-7595
Mailing Address - Country:US
Mailing Address - Phone:712-260-5896
Mailing Address - Fax:
Practice Address - Street 1:2215 IOWA ST
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-3845
Practice Address - Country:US
Practice Address - Phone:712-260-5896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer