Organization
HYDRATONIC MED SPA, LLC
Active
Other names
Tamika Cooke
Organization subpart
No
Provider details
NPI number
Authorized official
TAMIKA COOKE NP (APRN-C/CEO)
(863) 254-7363
Entity
Organization
Contact information
Practice address
1012 MISSISSIPPI AVE, CLEWISTON, FL 33440-5511
(863) 254-7363
Mailing address
PO BOX 824, CLEWISTON, FL 33440-0824
(863) 254-7363
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
10/16/2023
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