Organization
CHURCHLAND PODIATRY CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN ROBERT COOK DPM (PRESIDENT)
(757) 484-9535
Entity
Organization
Contact information
Practice address
108 AMERICAN LEGION RD, CHESAPEAKE, VA 23321-5657
(757) 484-9535
(757) 484-9540
Mailing address
108 AMERICAN LEGION RD, CHESAPEAKE, VA 23321-5657
(757) 484-9535
(757) 484-9540
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103000419
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
066587
ANTHEM
VA
Enumeration date
08/14/2007
Last updated
02/21/2008
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