Individual
LARRY COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
963 E STUART DR, GALAX, VA 24333-2407
(276) 238-8118
Mailing address
963 E STUART DR, GALAX, VA 24333-2407
(276) 238-8118
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305216807
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2305216807
VIRGINIA DEPARTMENT OF HEALTH
VA
Enumeration date
11/20/2024
Last updated
11/20/2024
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