Individual
BRIAN J COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1420 TUSCULUM BLVD, GREENEVILLE, TN 37745-4279
(423) 787-5063
(423) 787-5017
Mailing address
34 WEST RIDGEFIELD CT., GREENEVILLE, TN 37745
(423) 787-5063
(423) 787-5017
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7524
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446566
—
TN
01
—
3123654
BCBSTN
TN
01
—
621328385
FEDERAL TAX ID #
TN
Enumeration date
09/28/2006
Last updated
07/09/2007
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