Individual
MR. DUSTIN MICHAEL COOK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
45 GROVE ST, NEW CANAAN, CT 06840-5330
(203) 966-5752
(203) 966-7507
Mailing address
3 SEIR HILL RD, UNIT G3, NORWALK, CT 06850-1312
(203) 956-7510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
CT00729
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080007229CT02
ANTHEM BLUE CROSS BLUE SH
CT
01
—
ANC1555
OXFORD
CT
Enumeration date
07/22/2005
Last updated
07/08/2007
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