Individual
PETER DALTON COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T. M.S.
Contact information
Practice address
22 LINCOLN STREET, BRUNSWICK, ME 04011
(207) 729-1164
(207) 725-0905
Mailing address
22 LINCOLN STREET, BRUNSWICK, ME 04011
(207) 729-1164
(207) 725-0905
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT682
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277580099
—
ME
Enumeration date
10/03/2006
Last updated
06/28/2011
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