Provider Demographics
NPI:1740718113
Name:COOK, RHIANNON
Entity type:Individual
Prefix:
First Name:RHIANNON
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:RHIANNON
Other - Middle Name:
Other - Last Name:BRUNSTETER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:3412 E 84TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-1709
Mailing Address - Country:US
Mailing Address - Phone:405-334-9271
Mailing Address - Fax:
Practice Address - Street 1:6161 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1902
Practice Address - Country:US
Practice Address - Phone:918-494-1761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4616225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist