Provider Demographics
NPI:1215176508
Name:COOK, CHARLTON (PHD, ND)
Entity type:Individual
Prefix:DR
First Name:CHARLTON
Middle Name:
Last Name:COOK
Suffix:
Gender:M
Credentials:PHD, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 95
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-0095
Mailing Address - Country:US
Mailing Address - Phone:888-372-2254
Mailing Address - Fax:877-409-2718
Practice Address - Street 1:8890 TERRENE CT
Practice Address - Street 2:103
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-9532
Practice Address - Country:US
Practice Address - Phone:239-777-3466
Practice Address - Fax:877-409-2718
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No175F00000XOther Service ProvidersNaturopath
No175L00000XOther Service ProvidersHomeopath
No174H00000XOther Service ProvidersHealth Educator
No174400000XOther Service ProvidersSpecialist