Provider Demographics
NPI:1619130416
Name:COOKE, NATHAN BRUCE (MS LAT ATC)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:BRUCE
Last Name:COOKE
Suffix:
Gender:M
Credentials:MS LAT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3651
Mailing Address - Country:US
Mailing Address - Phone:717-815-1962
Mailing Address - Fax:717-849-1674
Practice Address - Street 1:441 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3651
Practice Address - Country:US
Practice Address - Phone:717-815-1962
Practice Address - Fax:717-849-1674
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART002362A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer