Individual
LESLIE N COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1675 DUNLAWTON AVE, PORT ORANGE, FL 32127-4755
(386) 761-1055
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA20950
FL
Other
Enumeration date
02/07/2008
Last updated
02/07/2008
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