Most Relevant Information
Provider Data
| NPI Number: | 1003588732 |
| Provider Name: | DAVITA J COOK MT |
| Entity Type: | Individual |
| Taxonomy Code: | 156F00000X |
| Specialty: | Technician/Technologist |
| License Number: | 1003588732 |
Most Important Dates
| Enumeration Date: | 09/30/2021 |
| Last Updated: | 02/22/2022 |
Provider Practice Location
4572 KAPP DR
HUBER HEIGHTS
OH
454245921
Practice Location Phone/Fax
| Phone: | 9372509938 |
| Fax: |
Provider Mailing Location
4572 KAPP DR
HUBER HEIGHTS
OH
454245921
Provider Mailing Phone/Fax
| Phone: | 9372509938 |
| Fax: |