Provider Demographics
NPI:1720506694
Name:J P COOK DC, PC
Entity Type:Organization
Organization Name:J P COOK DC, PC
Other - Org Name:PRECISION CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-635-2645
Mailing Address - Street 1:404 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-8815
Mailing Address - Country:US
Mailing Address - Phone:816-635-2645
Mailing Address - Fax:816-635-2845
Practice Address - Street 1:404 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:MO
Practice Address - Zip Code:64060-8815
Practice Address - Country:US
Practice Address - Phone:816-635-2645
Practice Address - Fax:816-635-2845
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JP COOK DC PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016013887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty