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General NPI Number Information
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NPI Number | 1962274522
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Entity Type | Individual
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Provider Name | SHANIE SPRING COOPER DC
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Gender | Female
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Dates
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Enumeration Date | 10/26/2023
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 1200 FERGUSON DR STE 2
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City | BENTON
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State | AR
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Zip | 72015-2947
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Country | US
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Telephone | 501-315-3310
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Fax |
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Provider Business Mailing Address
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Address Line | 164 STARBOARD CIR
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City | HOT SPRINGS
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State | AR
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Zip | 71901-9201
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Country | US
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Telephone | 501-693-4904
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 16423
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License Number State | AR
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