Organization
BALANCE & NEUROLOGICAL REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH COOKE PT, PHD (OWNER)
(816) 679-7056
Entity
Organization
Contact information
Practice address
3100 BROADWAY ST, SUITE 507, KANSAS CITY, MO 64111-2658
(816) 679-7056
(816) 931-7392
Mailing address
3100 BROADWAY ST, SUITE 507, KANSAS CITY, MO 64111-2658
(816) 679-7056
(816) 931-7392
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
11-02878
KS
2251N0400X
Neurology Physical Therapist
Primary
R0556
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32911028
BLUE CROSS/BLUE SHIELD
MO
01
—
399054
BLUE CROSS/BLUE SHIELD
KS
Enumeration date
10/11/2006
Last updated
08/22/2020
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