MEDICARE: CHRISTOPHER COOPER LMT

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	225700000X	Massage Therapist	019343	NY

General Provider Information

NPI Number	:	1548874910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER COOPER LMT

Provider Business Mailing Address
First Line	:	478 PIPING ROCK RD
Second Line	:
City	:	SEAFORD
State	:	NY
Zip	:	11783-1038
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	478 PIPING ROCK RD
Second Line	:
City	:	SEAFORD
State	:	NY
Zip	:	11783-1038
Country	:	US
Telephone Number	:	516-448-4359
Fax Number	:

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

Provider Enumeration Date	:	09/03/2020
Last Update Date	:	09/03/2020

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Directions to “ CHRISTOPHER COOPER LMT” Practice Location

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