Individual
MR. ANTONIO DESHUN COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
3384 FOREST HILL DR, BELDEN, MS 38826-9442
(662) 871-2080
Mailing address
3384 FOREST HILL DR, BELDEN, MS 38826-9442
(662) 871-2080
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
PTA3621
MS
225X00000X
Occupational Therapist
Primary
OT2248
MS
Other
Enumeration date
01/08/2007
Last updated
07/06/2011
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