Basic Information
| Provider Information | |||||||||
| NPI: | 1619225349 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COOK | ||||||||
| FirstName: | KORTNY | ||||||||
| MiddleName: | ALLEN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | D. P. T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 SUPERIOR DR STE 225 | ||||||||
| Address2: | |||||||||
| City: | SUPERIOR | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800278661 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036652603 | ||||||||
| FaxNumber: | 3036652605 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 W 144TH AVE STE 230 | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800239328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036652603 | ||||||||
| FaxNumber: | 0366526053 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2012 | ||||||||
| LastUpdateDate: | 03/13/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 11866 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.