ETHAN CORD COOPER

GALLUP, NM
NPI1851070395
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy163W00000X Registered Nurse
(Licence: AR  r098715)
Enumeration Date2023-07-12
Last Update Date2023-07-12
Business Address
ETHAN CORD COOPER RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1790
Mailing Address
ETHAN CORD COOPER RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1790