Kelly Marie Cooper, L.M.B.T
Individual provider Active NPI Massage Therapist · Fairview, NC
NPI 1265763098 · NPPES record last updated Jan 19, 2010
Key facts
- NPI
- 1265763098
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 5397 (NC)
- Practice address
- 25 Quail Hollow Rd
Fairview, NC 28730-8505 - Phone
- (828) 777-5083
- NPI assigned
- Jan 19, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5397 | NC | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 5397 | NC | Yes |
Addresses
Primary practice location
25 Quail Hollow Rd
Fairview, NC 28730-8505
Mailing address
2 Fairview Hills Dr
Fairview, NC 28730-9777
Phone (828) 777-5083
Other providers in Fairview, NC
- Theo Dickinson Chappell
- Angela Chavez
- Brooke L Coggins
- Lisa Anne Cole
- Anna Shumolis Conn
- Covenant Geriatrics PLLC
- Kathleen Rose Crosby
- Russell Clay Curtis
- Hannah Crowe Davis
- Michael Dimenna
All providers in Fairview, NC · Massage Therapist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.