Individual
MR. LOREN COOKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
567F SWEETWATER RD, FT WINGATE, NM 87316
(505) 979-1126
Mailing address
PO BOX 282, FT WINGATE, NM 87316
(505) 979-1126
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
NM
Other
Enumeration date
11/18/2015
Last updated
11/18/2015
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