Provider Demographics
NPI:1336206101
Name:COOK, SCOTT M (MS PT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:M
Last Name:COOK
Suffix:
Gender:M
Credentials:MS PT
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Mailing Address - Street 1:56 OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-4820
Mailing Address - Country:US
Mailing Address - Phone:774-281-0309
Mailing Address - Fax:401-729-2680
Practice Address - Street 1:111 BREWSTER ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4400
Practice Address - Country:US
Practice Address - Phone:401-729-2316
Practice Address - Fax:401-729-2680
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIPT 01840225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist