Provider Demographics
NPI:1588603831
Name:COOK, MATTHEW RYAN (ATC, LAT)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:RYAN
Last Name:COOK
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1491 S EAST ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-3031
Mailing Address - Country:US
Mailing Address - Phone:508-479-6450
Mailing Address - Fax:413-542-8187
Practice Address - Street 1:AMHERST COLLEGE
Practice Address - Street 2:ALUMNI GYM 2230
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002
Practice Address - Country:US
Practice Address - Phone:413-542-5303
Practice Address - Fax:413-542-8187
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16712255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer