Provider Demographics
NPI:1922718592
Name:COOK PERFORMANCE & THERAPY
Entity Type:Organization
Organization Name:COOK PERFORMANCE & THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MANAGER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:607-765-5907
Mailing Address - Street 1:136 STUTTS ROAD
Mailing Address - Street 2:SUITE 03
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117
Mailing Address - Country:US
Mailing Address - Phone:607-765-5907
Mailing Address - Fax:
Practice Address - Street 1:136 STUTTS ROAD
Practice Address - Street 2:SUITE 03
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117
Practice Address - Country:US
Practice Address - Phone:607-765-5907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty