Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 1422-024 | WI |
NPI | 1316005150 |
---|---|
Provider Name | Margaret Cooper |
First Address | Madison, WI 53715-1507 |
Second Address | Madison, WI 53715-1507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 08/07/2007 |