Individual
COOPER LOOMIS TERRY
Active
Individual
COOPER LOOMIS TERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
14854
MS
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
14854
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117049
—
MS
Enumeration date
07/05/2006
Last updated
04/10/2019
Update your record
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