Individual
MR. WILLIE FRANK COOK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EMT
Contact information
Practice address
358 GADDY ST, LAKE CITY, SC 29560-2339
(843) 539-6745
Mailing address
358 GADDY ST, LAKE CITY, SC 29560-2339
(843) 539-6745
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
SC019495
SC
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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