Individual
DENNIS COOK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12735 QUICKSILVER ST, WATERFORD, CA 95386-9326
(209) 596-7797
Mailing address
12735 QUICKSILVER ST, WATERFORD, CA 95386-9326
(209) 596-7797
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN292529
CA
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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