Provider Demographics
NPI:1174516603
Name:COOK, ALAN IRA (DC)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:IRA
Last Name:COOK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 HOWARD HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-9570
Mailing Address - Country:US
Mailing Address - Phone:707-444-8953
Mailing Address - Fax:
Practice Address - Street 1:341 HOWARD HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-9570
Practice Address - Country:US
Practice Address - Phone:707-444-8953
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19738111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor