KASSANDRA IVA MARIE COOPER

PEORIA, IL
NPI1710393913
Professional NameKASSANDRA COOPER TUCKER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207P00000X Emergency Medicine
(Licence: CA  20A15660)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: IL  125065930)
Enumeration Date2014-07-08
Last Update Date2024-11-14
Business Address
KASSANDRA IVA MARIE COOPER D.O.
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-655-6710
Mailing Address
KASSANDRA IVA MARIE COOPER D.O.
4601 DALE RD
MODESTO, CA 95356-9718
Phone number: 209-689-1492