Provider Demographics
NPI:1215280391
Name:COOK, DAVID LLOYD (MPT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LLOYD
Last Name:COOK
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8601 E. B ST.
Mailing Address - Street 2:LATCHMONT ELEMENTARY SCHOOL
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98445
Mailing Address - Country:US
Mailing Address - Phone:253-571-6200
Mailing Address - Fax:253-571-6262
Practice Address - Street 1:8601 E. B ST.
Practice Address - Street 2:LATCHMONT ELEMENTARY SCHOOL
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98445
Practice Address - Country:US
Practice Address - Phone:253-571-6200
Practice Address - Fax:253-571-6262
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008242225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist