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1851070395
ETHAN CORD COOPER
GALLUP, NM
NPI
1851070395
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: AR r098715)
Enumeration Date
2023-07-12
Last Update Date
2023-07-12
Business Address
ETHAN CORD COOPER RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1790
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Mailing Address
ETHAN CORD COOPER RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1790
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