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Individual
SHELLEY A COOPER
Active
Individual
SHELLEY A COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT10939
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT10939
LICENSE NUMBER
CA
Enumeration date
04/18/2007
Last updated
07/08/2007
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