Healthcare Provider Details

I. General information

NPI: 1982647111
Provider Name (Legal Business Name): LINN ARTHUR COOPER R.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DWIGHT DAVID EISENHOWER VAMC 4101 S. 4 ST. TRAFFICWAY
LEAVENWORTH KS
66048
US

IV. Provider business mailing address

23795 PARALLEL RD
TONGANOXIE KS
66086-3147
US

V. Phone/Fax

Practice location:
  • Phone: 913-682-2000
  • Fax: 913-758-4280
Mailing address:
  • Phone: 913-369-3167
  • Fax: 913-369-3167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-00541
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: