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Individual

DANIELLE MAE COOK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
73 TAYLOR RD, BURKE, NY 12917-2339
(518) 497-6678
Mailing address
73 TAYLOR RD, BURKE, NY 12917-2339

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT007716
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
380277697
MVP
NY
01
82113300803
MVP
NY
Enumeration date
06/02/2021
Last updated
06/02/2021
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