Individual
MR. STACY CAMERON COOK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CBRPA RPA
Contact information
Practice address
6847 KERRY VALLEY LN, CORDOVA, TN 38018-2848
(435) 224-4906
Mailing address
6847 KERRY VALLEY LN, CORDOVA, TN 38018-2848
(435) 224-4906
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
5614785-5400
UT
Other
Enumeration date
12/03/2013
Last updated
12/03/2013
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