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NPI Code Detail

MEDICARE: DR. KRISTAL COOPER DC

MEDICARE: DR. KRISTAL COOPER DC
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
1111N00000XChiropractor5143KY

General Provider Information

NPI Number : 1821241787
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTAL COOPER DC
Provider Business Mailing Address
First Line : 3488 SOLUTIONS CTR
Second Line : #773488
City : CHICAGO
State : IL
Zip : 60677-0001
Country : US
Telephone Number : 630-468-1831
Fax Number : 630-468-1834
Provider Business Practice Location Address
First Line : 3801 DYLAN PL
Second Line : SUITE 110
City : LEXINGTON
State : KY
Zip : 40514-1062
Country : US
Telephone Number : 859-296-2313
Fax Number : 859-296-2399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2008
Last Update Date : 12/16/2008

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Directions to “ DR. KRISTAL COOPER DC” Practice Location

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