Individual
JONATHAN COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
220 N ADAMS ST, SAN ANGELO, TX 76901-3363
(325) 659-5413
Mailing address
220 N ADAMS ST, SAN ANGELO, TX 76901-3363
(325) 659-5413
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L 062805-5
MN
Other
Enumeration date
10/25/2011
Last updated
10/25/2011
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