Provider Demographics
NPI:1952332892
Name:COOPER, WILLIAM RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RICHARD
Last Name:COOPER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6918 CYPRESS RD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2318
Mailing Address - Country:US
Mailing Address - Phone:754-701-5194
Mailing Address - Fax:754-701-5191
Practice Address - Street 1:6918 CYPRESS RD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2318
Practice Address - Country:US
Practice Address - Phone:754-701-5194
Practice Address - Fax:754-701-5191
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7805111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL382046700Medicaid