Organization
COOK MEDICAL ASSOCIATES, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE M TECHERT (BILLING)
(262) 656-8265
Entity
Organization
Contact information
Practice address
6308 8TH AVE STE 301, KENOSHA, WI 53143-5031
(262) 656-8265
Mailing address
6308 8TH AVE STE 301, KENOSHA, WI 53143-5031
(262) 656-8265
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22193
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427185255
MEDICARE RAILROAD
WI
Enumeration date
11/04/2008
Last updated
11/04/2008
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