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Individual

DR. LYLE COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
3533 GULF SHORES PARKWAY, GULF SHORES, AL 36542
(251) 968-2000
(251) 968-5953
Mailing address
PO BOX 899, GULF SHORES, AL 36547-0899
(251) 968-2000
(251) 968-5953

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1061
AL
111N00000X
Chiropractor
CH4882
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51161655
BLUE CROSS BLUE SHIELD
AL
Enumeration date
09/22/2006
Last updated
07/06/2020
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