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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003588732 NPPES
Ohio MEDICAID 0287258
Ohio Other 1003588732

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