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Organization
HOMETOWN WELLNESS PLLC
Active
Organization
HOMETOWN WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEIL L COOKE JR. FNP (OWNER)
(928) 377-0629
Entity
Organization
Contact information
Practice address
45 S REDWOOD ST # 750, COLORADO CITY, AZ 86021-6322
(928) 377-0629
Mailing address
PO BOX 750, COLORADO CITY, AZ 86021-0750
(928) 377-0629
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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