Basic Information
Provider Information
NPI: 1659491348
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COOK
FirstName: SARAH
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 720 COOL SPRINGS BLVD
Address2: SUITE 300
City: FRANKLIN
State: TN
PostalCode: 370672626
CountryCode: US
TelephoneNumber: 6157784066
FaxNumber: 6157789114
Practice Location
Address1: 12702 TOEPPERWEIN RD
Address2: SUITE 104
City: LIVE OAK
State: TX
PostalCode: 782333278
CountryCode: US
TelephoneNumber: 6157784066
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/29/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1010130TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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