Healthcare Provider Details

I. General information

NPI: 1275457657
Provider Name (Legal Business Name): RESILIENT CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 N SR 434 STE 1000
ALTAMONTE SPRINGS FL
32714-7037
US

IV. Provider business mailing address

840 N SR 434 STE 1000
ALTAMONTE SPRINGS FL
32714-7037
US

V. Phone/Fax

Practice location:
  • Phone: 407-542-2105
  • Fax:
Mailing address:
  • Phone: 407-542-2105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHNNY COOPER
Title or Position: DR/OWNER
Credential: DC
Phone: 321-262-4793