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General NPI Number Information
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NPI Number | 1861729865
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Entity Type | Organization
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Legal Business Name | COOPER CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 11/11/2009
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Last Update Date | 11/11/2009
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Provider Practice Location Address
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Address Line | 3004 SW 27TH AVE SUITE A
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City | AMARILLO
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State | TX
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Zip | 79109-3182
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Country | US
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Telephone | 806-372-3988
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Fax | 806-372-1839
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Provider Business Mailing Address
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Address Line | 3004 SW 27TH AVE SUITE A
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City | AMARILLO
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State | TX
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Zip | 79109-3182
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Country | US
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Telephone | 806-372-3988
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Fax | 806-372-1839
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Authorized Official
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Title or Position | OWNER
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Name | DR. KACI RAYE COOPER
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Credential | D.C.
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Telephone | 806-433-0138
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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 | 11147
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License Number State | TX
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