Provider Demographics
NPI:1154594596
Name:COOK, LEN MIKEL (PT, MPA)
Entity type:Individual
Prefix:MR
First Name:LEN
Middle Name:MIKEL
Last Name:COOK
Suffix:
Gender:M
Credentials:PT, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6405 METCALF AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202-4084
Mailing Address - Country:US
Mailing Address - Phone:913-831-2721
Mailing Address - Fax:
Practice Address - Street 1:4015 SW GAGE CENTER DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-1831
Practice Address - Country:US
Practice Address - Phone:785-273-1379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-005772251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic