Provider Demographics
NPI:1043559602
Name:COOK, TRENA MARLENE (PT, DPT)
Entity type:Individual
Prefix:
First Name:TRENA
Middle Name:MARLENE
Last Name:COOK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:TRENA
Other - Middle Name:M
Other - Last Name:FICHTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2222 SULLIVAN TRL
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-7958
Mailing Address - Country:US
Mailing Address - Phone:800-944-9782
Mailing Address - Fax:610-438-2046
Practice Address - Street 1:2744 ASHERS FORK DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-4943
Practice Address - Country:US
Practice Address - Phone:615-603-7690
Practice Address - Fax:615-603-7690
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8354225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist