Individual ProviderStaci Janae CookPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4515 E Central Ave, Ste A, Wichita, KS 67208-3915(316) 260-6869(316) 263-0003PECOS EnrollmentBased on the most recent information from CMS, provider Staci Janae Cook does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1295046274Provider TypeIndividualFull NameCook, Staci JanaeCredentialDPTGenderFemaleSole ProprietorNoEnumeration Date6/24/2010Last Updated2/18/2016Contact InformationPractice LocationPractice Address4515 E Central Ave, Ste A, Wichita, KS 67208-3915Phone(316) 260-6869Fax(316) 260-6872Mailing LocationMailing Address200 W Douglas Ave, Ste 1040, Wichita, KS 67202-3013Phone(316) 263-0003Fax(316) 263-1241Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense1104132Kansas