Provider Demographics
NPI:1205661725
Name:COOK, KASSIDY LYNN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:KASSIDY
Middle Name:LYNN
Last Name:COOK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11352 S BIRCHWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-5730
Mailing Address - Country:US
Mailing Address - Phone:303-895-9631
Mailing Address - Fax:
Practice Address - Street 1:19501 E MAINSTREET STE 200
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7408
Practice Address - Country:US
Practice Address - Phone:303-479-3633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0020094225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist