Provider Demographics
NPI:1588548846
Name:COOPER, EVA IRENE (LMT)
Entity type:Individual
Prefix:MS
First Name:EVA
Middle Name:IRENE
Last Name:COOPER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:EVA
Other - Middle Name:
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:855 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-1451
Mailing Address - Country:US
Mailing Address - Phone:801-989-8454
Mailing Address - Fax:
Practice Address - Street 1:60 S MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-6794
Practice Address - Country:US
Practice Address - Phone:801-989-8454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10232701-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist