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General NPI Number Information
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NPI Number | 1457316929
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Entity Type | Organization
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Legal Business Name | BETH COOPER DC PA
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3436 N ANDREWS AVE
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City | OAKLAND PARK
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State | FL
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Zip | 33309-6060
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Country | US
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Telephone | 954-390-0818
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Fax | 954-390-0817
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Provider Business Mailing Address
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Address Line | 3436 N ANDREWS AVE
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City | OAKLAND PARK
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State | FL
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Zip | 33309-6060
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Country | US
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Telephone | 954-390-0818
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Fax | 954-390-0817
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BETH COOPER
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Credential | DC
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Telephone | 954-390-0818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0007727
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License Number State | FL
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