Provider Demographics
NPI:1770461634
Name:COOPER, PEYTON BRICE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:PEYTON
Middle Name:BRICE
Last Name:COOPER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 BELAIR DR
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:38230-1224
Mailing Address - Country:US
Mailing Address - Phone:731-514-2805
Mailing Address - Fax:
Practice Address - Street 1:2060 RHINO XING
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358-5201
Practice Address - Country:US
Practice Address - Phone:731-613-2214
Practice Address - Fax:731-613-2215
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16634225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist