Individual
MS. CHARRELL COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT,DPT
Contact information
Practice address
3959 BROADWAY, NEW YORK, NY 10032-1559
(212) 305-6144
Mailing address
45 W 132ND ST, 8M, NEW YORK, NY 10037-3101
(212) 305-6144
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62034744
NY
Other
Enumeration date
04/07/2017
Last updated
04/07/2017
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