Individual
MR. JOHNATHAN G COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1305 W 44TH ST, ERIE, PA 16509-1209
(814) 866-2521
Mailing address
1305 W 44TH ST, ERIE, PA 16509-1209
(814) 866-2521
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN280804
PA
Other
Enumeration date
05/10/2012
Last updated
05/15/2012
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