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1205825148
GRANT WAYNE COOPER
GLENDALE, AZ
NPI
1205825148
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: AZ AP0851)
Enumeration Date
2005-10-13
Last Update Date
2007-07-08
Business Address
Mr. GRANT WAYNE COOPER MScN FNP
6336 W HONEYSUCKLE DR
GLENDALE, AZ 85310-1824
Phone number: 623-204-4914
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Mailing Address
Mr. GRANT WAYNE COOPER MScN FNP
6336 W HONEYSUCKLE DR
GLENDALE, AZ 85310-1824
Phone number: 623-204-4914
Copy
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