Provider Demographics
NPI:1477757284
Name:COOK, MATTHEW GLENN (DC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:GLENN
Last Name:COOK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 NEELY SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7674
Mailing Address - Country:US
Mailing Address - Phone:412-847-0066
Mailing Address - Fax:412-847-0067
Practice Address - Street 1:119 NEELY SCHOOL RD
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7674
Practice Address - Country:US
Practice Address - Phone:412-847-0066
Practice Address - Fax:412-847-0067
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor