Individual
ROBERT SHANE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
300 BLUE RIDGE ST, MARTINSVILLE, VA 24112-7261
(276) 340-7132
Mailing address
PO BOX 271, SPENCER, VA 24165-0271
(276) 340-7132
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000278
VA
Other
Enumeration date
07/26/2017
Last updated
07/26/2017
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