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General NPI Number Information
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NPI Number | 1780100883
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Entity Type | Individual
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Provider Name | ZACHERIE ADAM COOPER DPT
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Gender | Male
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Dates
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Enumeration Date | 08/21/2017
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 475 REED RD STE 103
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City | DALTON
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State | GA
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Zip | 30720-6316
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Country | US
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Telephone | 706-478-5656
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Fax | 762-257-6969
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Provider Business Mailing Address
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Address Line | 475 REED RD STE 103
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City | DALTON
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State | GA
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Zip | 30720-6316
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Country | US
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Telephone | 706-478-5656
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Fax | 762-257-6969
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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 | PT012998
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License Number State | GA
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