Provider Demographics
NPI:1164454054
Name:COOK, JOAN MARIE (R MR)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:MARIE
Last Name:COOK
Suffix:
Gender:F
Credentials:R MR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:156 ASBURY ROAD
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35951
Mailing Address - Country:US
Mailing Address - Phone:256-894-4440
Mailing Address - Fax:
Practice Address - Street 1:12119 US HIGHWAY 431 SOUTH
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-9344
Practice Address - Country:US
Practice Address - Phone:256-894-4440
Practice Address - Fax:256-894-4474
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
250338247100000X, 2471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
Not Answered2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging