Individual
ELAINE MICHELLE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
8261 WICKER AVE, SAINT JOHN, IN 46373-8878
(219) 365-1133
(219) 365-7703
Mailing address
8261 WICKER AVE, SAINT JOHN, IN 46373-8878
(219) 365-1133
(219) 365-7703
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05002423A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200423350
—
IN
Enumeration date
05/26/2006
Last updated
07/18/2013
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