Individual
MR. JONATHAN DAVID COOK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.T.
Contact information
Practice address
812 S PARK ST, CARROLLTON, GA 30117-4412
(770) 214-7323
Mailing address
812 S PARK ST, CARROLLTON, GA 30117-4412
(770) 214-7323
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
002803
GA
Other
Enumeration date
04/17/2006
Last updated
07/08/2007
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