Individual
MR. CHARLES JACK COOK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MBA
Contact information
Practice address
15095 AMARGOSA RD, SUITE 101, VICTORVILLE, CA 92394-1879
(760) 245-4695
(760) 245-5896
Mailing address
15095 AMARGOSA RD, SUITE 101, VICTORVILLE, CA 92394-1879
(760) 780-4016
(760) 780-4005
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/10/2007
Last updated
12/09/2010
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