TRACE COOPER

MERIDIAN, ID
NPI1326890096
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-04-04
Last Update Date2024-04-04
Business Address
TRACE COOPER DO Student
1401 E CENTRAL DR
MERIDIAN, ID 83642-8046
Phone number: 208-795-4266
Mailing Address
TRACE COOPER DO Student
1401 E CENTRAL DR
MERIDIAN, ID 83642-8046
Phone number:
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