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General NPI Number Information
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NPI Number | 1417208315
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Entity Type | Individual
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Provider Name | JARED D COOPER DPT
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Gender | Male
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Dates
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Enumeration Date | 10/02/2012
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 12 WALL ST STE I
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City | ASHEVILLE
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State | NC
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Zip | 28801-2710
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Country | US
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Telephone | 917-968-6362
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Fax |
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Provider Business Mailing Address
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Address Line | 73 HIGHLAND HILL LN
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City | FLAT ROCK
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State | NC
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Zip | 28731-0918
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Country | US
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Telephone |
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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 | P100311E
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License Number State | NC
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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 | 40QA01463800
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P21074
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License Number State | NC
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