Tyler J Cooperman
Individual provider Active NPI Physical Therapist · Little River, SC
NPI 1386246296 · NPPES record last updated Nov 16, 2020
Key facts
- NPI
- 1386246296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 10472 (SC)
- Practice address
- 4237 River Hills Dr Ste 120
Little River, SC 29566-6444 - Phone
- (843) 249-5616
- Fax
- (843) 249-1843
- NPI assigned
- Nov 16, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10472 | SC | Yes |
Addresses
Primary practice location
4237 River Hills Dr Ste 120
Little River, SC 29566-6444
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206
Other providers in Little River, SC
- Conway Hospital, Inc.
- Conway Hospital, Inc.
- Derion Conyers
- Emily C Cooper
- Rachael Mae Cooper
- Juan A Cornejo
- Jason Cox
- Michael Dean Cox
- Stephanie Faith Crawford
- Creating Meaning Counseling Services LLC
All providers in Little River, SC · Physical Therapist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2020. 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.