Individual
TERRY R COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1478 EAST HWY 162, MONTEZUMA CREEK, UT 84534
(435) 651-3700
Mailing address
25543 ROAD N.6 LOOP, CORTEZ, CO 81321-8404
(970) 565-8660
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
3406870501
UT
213E00000X
Podiatrist
540
CO
213ES0131X
Foot Surgery Podiatrist
Primary
540
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04023719
—
CO
01
—
50763
BCBS OF CO
CO
01
—
609395
HMO BCBS CO
CO
01
—
870579394001
ROCKY MOUNTAIN HMO
CO
Enumeration date
06/01/2005
Last updated
08/19/2019
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