Individual
MR. THOMAS RUSSELL COOKSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
100 CORPORATE PL, SUITE 103, PEABODY, MA 01960-3865
(978) 535-1213
(978) 535-5510
Mailing address
100 CORPORATE PL, SUITE 103, PEABODY, MA 01960-3865
(978) 535-1213
(978) 535-5510
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
8766
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0358649
—
MA
01
—
2835244
AETNA
MA
01
—
465520
TUFTS
MA
01
—
626323
HARVARD PILGRIM
MA
01
—
Y66951
BLUE CROSS BLUE SHIELD
MA
Enumeration date
08/23/2005
Last updated
07/08/2007
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