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Individual

MR. TERRY DEVERL COOK JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPSS

Contact information

Practice address
745 E 300 S, SALT LAKE CITY, UT 84102-2256
(801) 428-3490
Mailing address
117 W 400 S, SALT LAKE CITY, UT 84101-1916
(385) 200-0110

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
175T00000X
Peer Specialist
Primary
F23-103964
UT

Other

Enumeration date
11/29/2022
Last updated
07/22/2026
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