Individual
VERL DEAN COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
14873 HENSEN DR, NAMPA, ID 83651-8230
(208) 475-1986
Mailing address
14873 HENSEN DR, NAMPA, ID 83651-8230
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1016
ID
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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