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General NPI Number Information
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NPI Number | 1205026044
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Entity Type | Organization
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Legal Business Name | COOPER PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 235 N GILBERT ST
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City | HEMET
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State | CA
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Zip | 92543-4013
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Country | US
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Telephone | 951-658-9000
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Fax | 951-658-9585
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Provider Business Mailing Address
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Address Line | 235 N GILBERT ST
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City | HEMET
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State | CA
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Zip | 92543-4013
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Country | US
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Telephone | 951-658-9000
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. JAMES RAY COOPER
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Credential | P.T.
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Telephone | 951-658-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT15660
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License Number State | CA
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