| Doctor Name: | RYAN COOK |
| NPI Number: | 1023409851 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | MA057487 |
| Business Practice Address: | 713 Bethlehem Pike Montgomeryville, PA - 189369602 |
| Business Phone Number: | 2676953944 |
| Business Fax Number: | |
| Mailing Address: | 2801 Stanbridge St Apt A214, EAST NORRITON |
| State: | PA |
| Postal Code: | 194011639 |
| Phone Number: | 2156789946 |
| Fax Number: | |
| NPI Enumeration Date: | 02/16/2015 |
| NPI Last Update Date: | 02/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | MA057487 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |