Individual
TODD COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3828 E OMEGA CIR, MESA, AZ 85215-9792
(208) 569-3616
Mailing address
7416 E LOBO AVE, MESA, AZ 85209-4940
(208) 569-3616
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA1458
AZ
Other
Enumeration date
03/24/2016
Last updated
04/10/2018
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