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NPI Code Detail

MEDICARE: LAURA KELLY COOPER D.C.

MEDICARE: LAURA KELLY COOPER D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor08002028AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174660237
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA KELLY COOPER D.C.
Provider Business Mailing Address
First Line : 4201 S A ST
Second Line :
City : RICHMOND
State : IN
Zip : 47374-6049
Country : US
Telephone Number : 765-965-9500
Fax Number : 765-965-0432
Provider Business Practice Location Address
First Line : 4201 S A ST
Second Line :
City : RICHMOND
State : IN
Zip : 47374-6049
Country : US
Telephone Number : 765-965-9500
Fax Number : 765-965-0432
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 03/16/2023

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Directions to “ LAURA KELLY COOPER D.C.” Practice Location

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