=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275457657
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RESILIENT CHIROPRACTIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2026
-----------------------------------------------------
Last Update Date | 08/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 840 N SR 434 STE 1000
-----------------------------------------------------
City | ALTAMONTE SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32714-7037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-542-2105
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 840 N SR 434 STE 1000
-----------------------------------------------------
City | ALTAMONTE SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32714-7037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-542-2105
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DR/OWNER
-----------------------------------------------------
Name | DR. JOHNNY COOPER
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 321-262-4793
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------