Individual
BENJAMIN JAY COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-7822
Mailing address
4605 MOUNTAIN PARK RD, CHUBBUCK, ID 83202-1702
(208) 403-7689
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10258190-4405
UT
Other
Enumeration date
03/02/2017
Last updated
03/02/2017
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