Provider Demographics
NPI:1447487277
Name:COOK, STEVEN VINCENT (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:VINCENT
Last Name:COOK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 TYLER ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-3126
Mailing Address - Country:US
Mailing Address - Phone:970-460-6770
Mailing Address - Fax:
Practice Address - Street 1:1318 S COLLEGE AVE STE 5
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4174
Practice Address - Country:US
Practice Address - Phone:970-460-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6496111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor