1831382183 NPI number — PATRICK J. COOLEY, D.C., P.T., P.C.

Table of content: (NPI 1831382183)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831382183 NPI number — PATRICK J. COOLEY, D.C., P.T., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATRICK J. COOLEY, D.C., P.T., P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831382183
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
71 ALLEN ST
Provider Second Line Business Mailing Address:
SUITE 203
Provider Business Mailing Address City Name:
RUTLAND
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05701-4570
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-773-7700
Provider Business Mailing Address Fax Number:
802-773-7720

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
71 ALLEN ST
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
RUTLAND
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05701-4570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-773-7700
Provider Business Practice Location Address Fax Number:
802-773-7720
Provider Enumeration Date:
08/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
COOLEY
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
802-773-7700

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 68844 - PT . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: V169 . This is a "CDPHP GROUP" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: DE4922 . This is a "RAILROAD MEDICARE-GROUP #" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 68845 - CHIRO . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".




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