Provider Demographics
NPI:1730723719
Name:COOK, KYLE DAVID ARTHUR (DPT)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:DAVID ARTHUR
Last Name:COOK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 HILTON AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17315-3831
Mailing Address - Country:US
Mailing Address - Phone:717-758-3148
Mailing Address - Fax:
Practice Address - Street 1:2085 WAYNE RD
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17202-8586
Practice Address - Country:US
Practice Address - Phone:717-709-0668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-01
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305213301225100000X
PAPT027965225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist