Provider Demographics
NPI:1659065183
Name:CROOK, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:CROOK
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:PO BOX 6041
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-0717
Mailing Address - Country:US
Mailing Address - Phone:304-233-9627
Mailing Address - Fax:304-233-0056
Practice Address - Street 1:87 15TH ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3548
Practice Address - Country:US
Practice Address - Phone:304-233-9627
Practice Address - Fax:304-233-0056
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator