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General NPI Number Information
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NPI Number | 1700553138
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Entity Type | Individual
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Provider Name | BRYAN HARTSFIELD COOLEY JR.
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Gender | Male
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Dates
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Enumeration Date | 08/24/2021
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 170 JOE KNOX AVE
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City | MOORESVILLE
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State | NC
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Zip | 28117-9169
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Country | US
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Telephone | 704-360-2779
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Fax |
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Provider Business Mailing Address
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Address Line | 8918 BLAKENEY PROFESSIONAL DR STE 120
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City | CHARLOTTE
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State | NC
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Zip | 28277-6692
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Country | US
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Telephone | 704-900-8960
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Fax | 704-817-9523
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | P20752
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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 | P20752
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | P20752
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License Number State | NC
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