Kenneth Cook, OTA/L

NPI 1316281801 · on the registry since 2012 · sole proprietor

Practice

Address: 8211 W Ustick Rd
Boise, ID 83704
Phone: (208) 375-3700
Fax: (208) 375-3760
Organisation at this address: Leslie Leet Llc
Peak Medical Of Boise Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 11

Registry record

Primary taxonomy: 224Z00000X
224Z00000X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2012-11-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho