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Individual

KIMBERLY COOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2255 DUNN AVE STE 207, JACKSONVILLE, FL 32218-4739
(904) 757-9119
Mailing address
125 ELMWOOD DR, JACKSONVILLE, FL 32259-3031
(904) 269-2833

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTA 1691
LICENSE #
FL
Enumeration date
08/30/2006
Last updated
07/08/2007
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