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NPI Code Detail

MEDICARE: MICHAEL ANTHONY COOPER II OTR/L

MEDICARE: MICHAEL ANTHONY COOPER II OTR/L
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
1225X00000XOccupational TherapistOT008456GA

General Provider Information

NPI Number : 1922783828
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ANTHONY COOPER II OTR/L
Provider Business Mailing Address
First Line : 3708 NORTHSIDE DR
Second Line :
City : MACON
State : GA
Zip : 31210-2404
Country : US
Telephone Number : 478-745-4206
Fax Number :
Provider Business Practice Location Address
First Line : 2510 GA HIGHWAY 127
Second Line :
City : KATHLEEN
State : GA
Zip : 31047-2828
Country : US
Telephone Number : 789-711-1534
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2023
Last Update Date : 08/21/2023

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Directions to “ MICHAEL ANTHONY COOPER II OTR/L” Practice Location

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