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1023417771
DALE COOPER
MADISON, MS
NPI
1023417771
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: NC PTA5588)
Enumeration Date
2014-08-19
Last Update Date
2014-08-19
Business Address
-- DALE COOPER
28 PEACHTREE LN
MADISON, MS 39110-7452
Phone number: 800-330-7711
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Mailing Address
-- DALE COOPER
28 PEACHTREE LN
MADISON, MS 39110-7452
Phone number:
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