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Individual

MR. JEZERIAH WAYNE COOK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
9 MANHATTAN SQ STE A, HAMPTON, VA 23666-6262
(757) 838-6335
(757) 838-0612
Mailing address
9 MANHATTAN SQ STE A, HAMPTON, VA 23666-6262
(757) 838-6335
(757) 838-0612

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110002140
VA

Other

Enumeration date
06/28/2006
Last updated
05/16/2014
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