Provider Demographics
NPI:1184802902
Name:COOK, CYNTHIA RUTH (LAC)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:RUTH
Last Name:COOK
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 GOLDHILLS PL S
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-1101
Mailing Address - Country:US
Mailing Address - Phone:719-221-1152
Mailing Address - Fax:
Practice Address - Street 1:7030 SOUTH YOSRMITE
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112
Practice Address - Country:US
Practice Address - Phone:303-996-3244
Practice Address - Fax:303-721-0972
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO189171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist