Cook, Davita J
Cook, Davita J is an sole proprietor health care provider with primary practice located at 4572 Kapp Dr , Huber Heights OH 45424-5921. She recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Technician/Technologist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Specialist/Technologist, Laboratories / Clinical Medical Laboratory. Laboratories / Clinical Medical Laboratory is her primary health care specialty. Cook, Davita J can be contacted via phone (937) 250-9938.Contact Information
Primary practice address
4572 Kapp Dr
Huber Heights OH 45424-5921
Phone: (937) 250-9938
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Technician/Technologist | 156F00000X | 1003588732 | Ohio |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Specialist/Technologist | 225500000X | 1003588732 | Ohio |
Eye and Vision Services Providers / Technician/Technologist | 156F00000X | 6009038 | New York |
Laboratories / Clinical Medical Laboratory | 291U00000X | 1003588732 | Ohio |
Profile Details
NPI number | 1003588732 |
---|---|
LBN Legal business name | Cook, Davita J |
Credentials | Medical Technologist (MT) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Sep 30th, 2021 |
Last updated | Feb 22nd, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1003588732 | NPPES |
Ohio | MEDICAID | 0287258 | |
Ohio | Other | 1003588732 |
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