Provider Demographics
NPI:1851966436
Name:COOK, CHRISTINE M (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:M
Last Name:COOK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1981 GRAMERCY CIR
Mailing Address - Street 2:
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1780
Mailing Address - Country:US
Mailing Address - Phone:404-375-6924
Mailing Address - Fax:
Practice Address - Street 1:3938 LAVISTA ROAD
Practice Address - Street 2:SUITE 128
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084678
Practice Address - Country:US
Practice Address - Phone:404-375-6924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0147842251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology