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Individual

JESSICA A COOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
147 REINHARDT COLLEGE PKWY, SUITE 9, CANTON, GA 30114-5641
(770) 345-3057
(770) 345-3154
Mailing address
147 REINHARDT COLLEGE PKWY, SUITE 9, CANTON, GA 30114-5641
(770) 345-3057
(770) 345-3154

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA003073
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTA003073
PTA LICENSE
GA
Enumeration date
03/14/2013
Last updated
03/14/2013
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