Provider Demographics
NPI:1164844049
Name:COOPER, HEIDI M (PT)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:M
Last Name:COOPER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:444 STOCKBRIDGE RD
Mailing Address - Street 2:P O BOX 30
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1295
Mailing Address - Country:US
Mailing Address - Phone:413-528-9311
Mailing Address - Fax:413-528-2863
Practice Address - Street 1:442 STOCKBRIDGE RD
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1295
Practice Address - Country:US
Practice Address - Phone:413-644-0104
Practice Address - Fax:413-644-0274
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist