Individual
LARRY C COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2914 JERRY ST, PRESCOTT, AZ 86301-7609
(928) 778-3571
Mailing address
2914 JERRY ST, PRESCOTT, AZ 86301-7609
(928) 778-3571
Taxonomy
Speciality
Code
Description
License number
State
126900000X
Dental Laboratory Technician
Primary
—
—
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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