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1942545991
CLAYTON E COOPER
TISHOMINGO, OK
NPI
1942545991
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2012-12-03
Last Update Date
2012-12-03
Business Address
-- CLAYTON E COOPER
801 E MAIN ST
TISHOMINGO, OK 73460-2351
Phone number: 580-371-3776
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Mailing Address
-- CLAYTON E COOPER
200 MICHELLE DR
POTEAU, OK 74953-2083
Phone number: 918-839-0377
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