Individual
ANDREA L COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1002 RAINBOW CT, FAIRBORN, OH 45324-6365
(800) 824-9861
(937) 438-8630
Mailing address
6551 CENTERVILLE BUSINESS PKWY STE 10, DAYTON, OH 45459-2695
(937) 415-9100
(937) 415-9191
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT013406
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0464979
—
OH
Enumeration date
09/29/2021
Last updated
05/22/2025
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