Individual
STEPHANIE COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
2100 S 2ND AVE APT 5C, POCATELLO, ID 83201-6920
(208) 604-3185
Mailing address
2100 S 2ND AVE APT 5C, POCATELLO, ID 83201-6920
(208) 604-3185
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
ID
Other
Enumeration date
11/04/2008
Last updated
11/04/2008
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