Individual
JORDAN DANIEL COOKSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
731 MIDDLE CREEK RD, SEVIERVILLE, TN 37862-5016
(865) 429-6156
Mailing address
8511 THORN GROVE PIKE, KNOXVILLE, TN 37914-9391
(256) 960-1407
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7731
TN
Other
Enumeration date
02/16/2021
Last updated
02/16/2021
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