Organization
COOK FOOT & ANKLE SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY COOK (OFFICE MANAGER)
(435) 734-9623
Entity
Organization
Contact information
Practice address
990 MEDICAL DR, #U3, BRIGHAM CITY, UT 84302-4713
(435) 734-9623
(435) 752-7159
Mailing address
550 E 1400 N, #B, LOGAN, UT 84341-2406
(435) 752-9011
(435) 752-7159
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
72759630501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52874126705
—
UT
Enumeration date
10/05/2011
Last updated
05/04/2021
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