Healthcare Provider Details

I. General information

NPI: 1831382183
Provider Name (Legal Business Name): PATRICK J. COOLEY, D.C., P.T., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 03/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 ALLEN ST SUITE 203
RUTLAND VT
05701-4570
US

IV. Provider business mailing address

71 ALLEN ST SUITE 203
RUTLAND VT
05701-4570
US

V. Phone/Fax

Practice location:
  • Phone: 802-773-7700
  • Fax: 802-773-7720
Mailing address:
  • Phone: 802-773-7700
  • Fax: 802-773-7720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK J. COOLEY
Title or Position: OWNER
Credential: D.C., P.T.
Phone: 802-773-7700