Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 012818 | OH |
N | 2251S0007X | Physical Therapist - Sports | 012818 | OH |
N | 2251X0800X | Physical Therapist - Orthopedic | 012818 | OH |
NPI | 1033548763 |
---|---|
Provider Name | Dr. Andrew Samuel Cook |
First Address | Springboro, OH 45066-7407 |
Second Address | West Chester, OH 45069-2442 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2013 |
Last Update Date | 15/08/2016 |