Provider Demographics
NPI:1457832198
Name:COOPER, NATHAN A (ATC)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:A
Last Name:COOPER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 PATRICIAS LN
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-1570
Mailing Address - Country:US
Mailing Address - Phone:484-844-2872
Mailing Address - Fax:
Practice Address - Street 1:120 PATRICIAS LN
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-1570
Practice Address - Country:US
Practice Address - Phone:484-844-2872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer