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General NPI Number Information
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NPI Number | 1528451952
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Entity Type | Organization
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Legal Business Name | COOPER CHIROPRACTIC CENTER INC.
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Dates
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Enumeration Date | 03/10/2015
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Last Update Date | 03/10/2015
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Provider Practice Location Address
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Address Line | 101 N GARDEN AVE SUITE 100
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City | CLEARWATER
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State | FL
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Zip | 33755-4189
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Country | US
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Telephone | 727-446-1141
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Fax | 727-466-9721
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Provider Business Mailing Address
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Address Line | 101 N GARDEN AVE SUITE 100
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City | CLEARWATER
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State | FL
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Zip | 33755-4189
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Country | US
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Telephone | 727-446-1141
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES D COOPER
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Credential | D.C.
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Telephone | 727-446-1141
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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 | CH6122
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License Number State | FL
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