Provider Demographics
NPI:1811452386
Name:COOKE, MARINA MATHILDE-FRANCOIS (PTA)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:MATHILDE-FRANCOIS
Last Name:COOKE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 S SETTLERS LN
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-3682
Mailing Address - Country:US
Mailing Address - Phone:440-251-8551
Mailing Address - Fax:
Practice Address - Street 1:200 COMMERCE PL
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:OH
Practice Address - Zip Code:44041-1948
Practice Address - Country:US
Practice Address - Phone:440-361-3066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH07930225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant