Individual
MRS. LISA A COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4 ROYAL OAKS DR, CENTEREACH, NY 11720-3627
(631) 332-6755
Mailing address
4 ROYAL OAKS DR, CENTEREACH, NY 11720-3627
(631) 332-6755
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
007255-01
NY
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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