Provider Demographics
NPI:1952430100
Name:COOPER, JOSEPH A JR (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:COOPER
Suffix:JR
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:PO BOX 850
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-0850
Mailing Address - Country:US
Mailing Address - Phone:845-691-8185
Mailing Address - Fax:845-691-7008
Practice Address - Street 1:216 STATE ROUTE 299
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-2524
Practice Address - Country:US
Practice Address - Phone:845-691-8185
Practice Address - Fax:845-691-7008
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008762-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor