Individual
MS. SHARON IRENE COOK IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
3618 N HAMPTON DR NW, KENNESAW, GA 30144-1169
(770) 422-0101
(770) 422-2097
Mailing address
3618 N HAMPTON DR NW, KENNESAW, GA 30144-1169
(770) 422-0101
(770) 422-2097
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1400
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000624742C
—
GA
01
—
307628
WELLCARE
GA
Enumeration date
12/29/2006
Last updated
10/15/2008
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