Individual
MADISON RENE COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 W ALBANY DR APT 1432, BROKEN ARROW, OK 74012-5841
(918) 813-3966
Mailing address
1800 W ALBANY DR APT 1432, BROKEN ARROW, OK 74012-5841
(918) 813-3966
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2504
OK
Other
Enumeration date
08/13/2015
Last updated
08/13/2015
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