Provider Demographics
NPI:1962274522
Name:COOPER, SHANIE SPRING (DC)
Entity type:Individual
Prefix:
First Name:SHANIE
Middle Name:SPRING
Last Name:COOPER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SHANIE
Other - Middle Name:
Other - Last Name:RUSHING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:164 STARBOARD CIR
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-9201
Mailing Address - Country:US
Mailing Address - Phone:501-693-4904
Mailing Address - Fax:
Practice Address - Street 1:1200 FERGUSON DR STE 2
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-2947
Practice Address - Country:US
Practice Address - Phone:501-315-3310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16423111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor