Provider Demographics
NPI:1710199450
Name:COOK, BRANDY ELIZABETH (DO)
Entity Type:Individual
Prefix:DR
First Name:BRANDY
Middle Name:ELIZABETH
Last Name:COOK
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1000 E STURGIS ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SAINT JOHNS
Mailing Address - State:MI
Mailing Address - Zip Code:48879-2068
Mailing Address - Country:US
Mailing Address - Phone:989-224-1452
Mailing Address - Fax:989-224-1453
Practice Address - Street 1:1000 E STURGIS ST
Practice Address - Street 2:SUITE 3
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-2068
Practice Address - Country:US
Practice Address - Phone:989-224-1452
Practice Address - Fax:989-224-1453
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2017-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101016172207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology