MEDICARE: MR. CHRISTOPHER COOPER L. AC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	65.000285	OH

General Provider Information

NPI Number	:	1235530015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER COOPER L. AC

Provider Business Mailing Address
First Line	:	4657 OLENTANGY BLVD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-2539
Country	:	US
Telephone Number	:	614-206-6714
Fax Number	:

Provider Business Practice Location Address
First Line	:	4657 OLENTANGY BLVD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-2539
Country	:	US
Telephone Number	:	614-206-6714
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2014
Last Update Date	:	09/11/2014

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