Individual
L COOPER LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
640 KEATING ROAD, FAIRFIELD, BATESVILLE, MS 38606
(662) 563-2345
Mailing address
130 HILLCREST DR, BATESVILLE, MS 38606-9311
(662) 563-0378
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0819
MS
Other
Enumeration date
01/25/2011
Last updated
01/25/2011
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