Dr. Charles R Cook
Chiropractic Sports Physician
108 Creek Ln S
Jordan
, Minnesota 55352-1202
Dr. Charles R Cook
Chiropractic Sports Physician
108 Creek Ln S
Jordan
, Minnesota 55352-1202
(952) 492-6363
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About
Features
Specialties
- Chiropractic Sports Physician
Languages spoken
- English
Location
First Address
- Dr. Charles R Cook
- 108 Creek Ln S
- Jordan, MN
- Zip : 55352-1202
- Phone : (952) 492-6363
Second Address
- Dr. Charles R Cook
- 108 Creek Ln S
- Jordan, MN
- Zip : 55352-1202
- Fax : (952) 492-5129
- Phone : (952) 492-6363
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111NS0005X | Chiropractic Sports Physician | 3717 | MN |
National Provider Identifier
| NPI | 1134189202 |
|---|---|
| Provider Name | Dr. Charles R Cook |
| First Address | Jordan, MN 55352-1202 |
| Second Address | Jordan, MN 55352-1202 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/03/2006 |
| Last Update Date | 28/07/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 35719800 | (05) | MN |
| 460717100 | (05) | MN |
| 73D29CH | BCBS OFFICE ID (01) | MN |
| 73D30CO | BCBS PERSONAL ID (01) | MN |
| U68828 | (02) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.