Individual
KEVIN R COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
6201 STELLHORN RD, FORT WAYNE, IN 46815-5349
(260) 485-0755
Mailing address
6201 STELLHORN RD, FORT WAYNE, IN 46815-5349
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26019308A
IN
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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