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Contact Information

CHARLES R COOK, D. C.
108 CREEK LN S
JORDAN, MN55352-1202
 Phone: 952-492-6363
 Fax: 952-492-5129
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Physician

111NS0005X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for CHARLES R COOK · (Male)

NPI Number 1134189202
Status Active
Credentials D. C.
Entity Individual
Enumeration date 03/24/2006
Last updated 07/28/2010 - About 16 years ago
Sole proprietor 1 Yes
Identifiers
  • MN License # 3717
  • MN Medicaid 35719800
  • MN Medicaid 460717100
  • MN Other 73D29CH BCBS OFFICE ID
  • MN Other 73D30CO BCBS PERSONAL ID
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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