NPI 1073064226

Theavis Cooper, ATC

Practitioner Athletic Trainer Wesson, MS

Practice location

Address: 1028 Jc Redd Dr Wesson, Mississippi 39191, Wesson, MS 39191
Phone: (601) 643-8479
Mailing address: 507 Highway 51 N PO Box 948, Brookhaven, MS 39601

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

Other Specialist/Technologist providers in Mississippi →

Registry record

NPI: 1073064226
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Oct 2016
Record last updated: 26 Feb 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.