Provider Demographics
NPI:1679729461
Name:COOK, DANIEL S (RRT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:S
Last Name:COOK
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6234 OLD RANGELINE RD
Mailing Address - Street 2:
Mailing Address - City:THEODORE
Mailing Address - State:AL
Mailing Address - Zip Code:36582-5244
Mailing Address - Country:US
Mailing Address - Phone:251-581-4721
Mailing Address - Fax:
Practice Address - Street 1:6234 OLD RANGELINE RD
Practice Address - Street 2:
Practice Address - City:THEODORE
Practice Address - State:AL
Practice Address - Zip Code:36582-5244
Practice Address - Country:US
Practice Address - Phone:251-581-4721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2262227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered