Provider Demographics
NPI:1134854573
Name:ROOK, CHARLENE M
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:M
Last Name:ROOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 N STATE ROUTE 590
Mailing Address - Street 2:
Mailing Address - City:GRAYTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43432-9787
Mailing Address - Country:US
Mailing Address - Phone:419-340-5701
Mailing Address - Fax:
Practice Address - Street 1:3100 W CENTRAL AVE STE 225
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-2960
Practice Address - Country:US
Practice Address - Phone:419-726-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker