Individual
MR. EDWARD CLEARY COOK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
25117 SW PARKWAY AVE, SUITE D, WILSONVILLE, OR 97070-9697
(503) 570-3665
Mailing address
6029 NE BROADWAY ST, PORTLAND, OR 97213-4263
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4867
OR
Other
Enumeration date
10/29/2010
Last updated
10/29/2010
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