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1790034502
AMANDA BLAIZE COOPER
SPRINGFIELD, MO
NPI
1790034502
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO 2012017269)
Enumeration Date
2012-09-07
Last Update Date
2012-09-07
Business Address
-- AMANDA BLAIZE COOPER ATC
2135 S FREEMONT AVE
SPRINGFIELD, MO 65804
Phone number: 417-820-2000
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Mailing Address
-- AMANDA BLAIZE COOPER ATC
2135 S FREEMONT AVE
SPRINGFIELD, MO 65804
Phone number: 417-820-2000
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