# COOK REHABILITATION MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104295393
- **Authorized official:** DR. JUDE THOMAS COOK M.D. (MANAGER)
- **Authorized official phone:** (402) 432-9512

## Contact information

- **Practice address:** 8338 W 13TH ST N, MEDICAL DIRECTOR, WICHITA, KS 67212-2900
- **Practice address phone:** (402) 432-9512
- **Mailing address:** 8338 W 13TH ST N, MEDICAL DIRECTOR, WICHITA, KS 67212-2900
- **Mailing address phone:** (402) 432-9512

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 04-38402 | KS | Yes |

## Other

- **Enumeration date:** 09/17/2015
- **Last updated:** 09/17/2015