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Individual
MICHAEL S COOK
Active
Individual
MICHAEL S COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104001063
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
324500
ANTHEM BCBS
VA
01
—
541901720
TAX ID
VA
Enumeration date
07/24/2006
Last updated
06/11/2019
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