Doctor Name: | JUSTIN COOPER |
NPI Number: | 1417260654 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 4311 |
Business Practice Address: | 505 S Aspen Ave Broken Arrow, OK - 740122296 |
Business Phone Number: | 9189945333 |
Business Fax Number: | 9189945334 |
Mailing Address: | 6585 S Yale Ave, Ste 200 TULSA |
State: | OK |
Postal Code: | 741368384 |
Phone Number: | 9184812767 |
Fax Number: | 9184817611 |
NPI Enumeration Date: | 07/16/2010 |
NPI Last Update Date: | 12/12/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 4311 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
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 |