Provider Demographics
NPI:1710758602
Name:COOK, ANNA MARIE (CMT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:COOK
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2444 W BRITT DAVID RD APT 1710
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-6112
Mailing Address - Country:US
Mailing Address - Phone:727-484-0012
Mailing Address - Fax:
Practice Address - Street 1:3174 BAKER DR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2112
Practice Address - Country:US
Practice Address - Phone:310-487-3256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist