Provider Demographics
NPI:1265716328
Name:COOPER, MARSHA SOLLENBERGER (DPT)
Entity type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:SOLLENBERGER
Last Name:COOPER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 803
Mailing Address - Street 2:1195 HISEY AVENUE
Mailing Address - City:WOODSTOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22664
Mailing Address - Country:US
Mailing Address - Phone:540-459-7772
Mailing Address - Fax:540-459-7782
Practice Address - Street 1:1195 HISEY AVENUE
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664
Practice Address - Country:US
Practice Address - Phone:540-459-7772
Practice Address - Fax:540-459-7782
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06417Medicare UPIN