Basic Information
| Provider Information | |||||||||
| NPI: | 1730821125 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COOK | ||||||||
| FirstName: | JULIANE | ||||||||
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| Credential: | CEP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 125 W 3RD ST UNIT 202 | ||||||||
| Address2: | |||||||||
| City: | RIFLE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 816502216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4352255138 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1906 BLAKE AVE | ||||||||
| Address2: | |||||||||
| City: | GLENWOOD SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 816014259 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9709456535 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2022 | ||||||||
| LastUpdateDate: | 04/07/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Y00000X | 822533 | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Clinical Exercise Physiologist |
No ID Information.