Organization
COOPER FAMILY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCY LYNN COOPER D.C. (OWNER)
(636) 379-9105
Entity
Organization
Contact information
Practice address
9103 PHOENIX VILLAGE PKWY, SUITE F, O FALLON, MO 63368-4279
(636) 265-2566
(866) 418-4148
Mailing address
9103 PHOENIX VILLAGE PKWY, SUITE F, O FALLON, MO 63368-4279
(636) 265-2566
(866) 418-4148
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2000144756
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139154
ANTHEM BLUE CROSS BLUE SHIELD
MO
01
—
38309
GHP/CMR
MO
01
—
432179
HEALTHLINK
MO
01
—
7997538
AETNA
MO
Enumeration date
08/04/2008
Last updated
11/11/2014
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