Individual
ETHAN GREGORY COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5729 NANCY DR SW, WYOMING, MI 49418-9789
(616) 206-6654
Mailing address
5729 NANCY DR SW, WYOMING, MI 49418
(616) 206-6654
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/14/2017
Last updated
04/14/2017
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