Provider Demographics
NPI:1174721187
Name:COOK, SHERRI LYNN (PTA)
Entity type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:LYNN
Last Name:COOK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5144 HAYCRAFT RD
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-8101
Mailing Address - Country:US
Mailing Address - Phone:270-688-8821
Mailing Address - Fax:
Practice Address - Street 1:2420 W 3RD ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-0328
Practice Address - Country:US
Practice Address - Phone:270-685-4705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA1089225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant