Provider Demographics
NPI:1427148139
Name:COOK, AFRICA (PT)
Entity type:Individual
Prefix:
First Name:AFRICA
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:30 GLENN ST # 402
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-3254
Mailing Address - Country:US
Mailing Address - Phone:954-848-3834
Mailing Address - Fax:
Practice Address - Street 1:10820 E 45TH ST STE 101
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-3803
Practice Address - Country:US
Practice Address - Phone:918-274-7902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008826225100000X
CA35847225100000X
TN8258225100000X
OK5535225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist