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General NPI Number Information
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NPI Number | 1205898863
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Entity Type | Individual
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Provider Name | AMY L COOPER DPT
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Gender | Female
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3180 NORTH BUTLER AVE. BLDG. 300
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City | FARMINGTON
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State | NM
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Zip | 87401
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Country | US
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Telephone | 505-326-2460
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Fax | 505-325-1943
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Provider Business Mailing Address
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Address Line | 255 ELK RIDGE RD
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City | DURANGO
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State | CO
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Zip | 81301-8972
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Country | US
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Telephone | 970-946-9380
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 8249
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2930
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License Number State | NM
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