Doctor Name: | KELLY L COOPER |
NPI Number: | 1023377538 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 2305207085 |
Business Practice Address: | 4660 Kenmore Ave Suite 420 Alexandria, VA - 223041313 |
Business Phone Number: | 7037511008 |
Business Fax Number: | 7037511118 |
Mailing Address: | 5252 Lyngate Ct, Ste 203 BURKE |
State: | VA |
Postal Code: | 220151672 |
Phone Number: | 7032392300 |
Fax Number: | 7032392301 |
NPI Enumeration Date: | 05/04/2012 |
NPI Last Update Date: | 09/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2305207085 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |