Organization
COOPER CLINIC, PA
Active
Organization
COOPER CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA G ASTIN (DIRECTOR, BUSINESS SERVICES)
(479) 274-2004
Entity
Organization
Contact information
Practice address
6801 ROGERS AVE, FORT SMITH, AR 72903-4067
(479) 274-5300
Mailing address
PO BOX 17025, FORT SMITH, AR 72917-7025
(479) 274-2000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1725
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT1725
PHYSICAL THERAPY LICENSE
AR
Enumeration date
08/26/2015
Last updated
08/26/2015
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