MEDICARE: JUSTIN COOPER PT

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	225100000X	Physical Therapist	CP053274T	VA
2	225100000X	Physical Therapist	21006	MD

General Provider Information

NPI Number	:	1326101510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN COOPER PT

Provider Business Mailing Address
First Line	:	6410 ROCKLEDGE DR
Second Line	:	NRH REGIONAL REHAB - SUITE 600
City	:	BETHESDA
State	:	MD
Zip	:	20817-1809
Country	:	US
Telephone Number	:	301-581-8054
Fax Number	:	301-564-0284

Provider Business Practice Location Address
First Line	:	1407 YORK RD
Second Line	:	SUITE 100
City	:	LUTHERVILLE
State	:	MD
Zip	:	21093-6097
Country	:	US
Telephone Number	:	301-581-8054
Fax Number	:	301-564-0284

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	03/18/2026

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Directions to “ JUSTIN COOPER PT” Practice Location

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