Provider Demographics
NPI:1093775306
Name:COOPER & ASSOCIATES PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:COOPER & ASSOCIATES PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:248-851-7050
Mailing Address - Street 1:29805 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2317
Mailing Address - Country:US
Mailing Address - Phone:248-851-7050
Mailing Address - Fax:248-851-8597
Practice Address - Street 1:29805 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2317
Practice Address - Country:US
Practice Address - Phone:248-851-7050
Practice Address - Fax:248-851-8597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501000015261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F35713Medicare ID - Type UnspecifiedPROVIDER NUMBER