Individual
RUSSELL COOK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5507 N ROUTE 130, PENNSAUKEN, NJ 08110-1803
(856) 488-6306
Mailing address
5507 N ROUTE 130, PENNSAUKEN, NJ 08110-1803
(856) 488-6306
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
NJ
Other
Enumeration date
06/20/2018
Last updated
06/20/2018
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