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Individual
WAYNE MAX COOPER
Active
Individual
WAYNE MAX COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2015558
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172242301
—
TX
Enumeration date
08/08/2018
Last updated
08/08/2018
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