Individual
DR. JEFFREY GEORGE COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
574 W 1600 N, OREM, UT 84057-2556
(801) 210-9339
(801) 960-2887
Mailing address
4101 N 190 W, PROVO, UT 84604-6218
(208) 360-3371
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10313631-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932541489
—
AZ
Enumeration date
07/25/2013
Last updated
10/28/2021
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