JERRY D COOPER

IDAHO FALLS, ID
NPI1942299151
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy213E00000X Podiatrist
(Licence: ID  P126)
Enumeration Date2005-10-19
Last Update Date2013-06-11
Business Address
Dr. JERRY D COOPER D.P.M.
2565 CHANNING WAY
IDAHO FALLS, ID 83404-7516
Phone number: 208-523-2928
Mailing Address
Dr. JERRY D COOPER D.P.M.
2565 CHANNING WAY
IDAHO FALLS, ID 83404-7516
Phone number: 208-523-2928
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