Provider Demographics
NPI:1467759696
Name:MCCOOK THERAPY
Entity type:Organization
Organization Name:MCCOOK THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HEUMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:OT/L
Authorized Official - Phone:605-421-1728
Mailing Address - Street 1:511 S. NEBRASKA
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:SD
Mailing Address - Zip Code:57058
Mailing Address - Country:US
Mailing Address - Phone:605-421-1728
Mailing Address - Fax:605-425-9463
Practice Address - Street 1:511 S. NEBRASKA
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:SD
Practice Address - Zip Code:57058
Practice Address - Country:US
Practice Address - Phone:605-421-1728
Practice Address - Fax:605-425-9463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0119261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation