Individual
JACKIE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3938 JOHN F KENNEDY PKWY UNIT 11C, FORT COLLINS, CO 80525-3087
(970) 227-6184
Mailing address
6132 TILDEN ST, FORT COLLINS, CO 80528-7117
(970) 227-6184
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
CO
Other
Enumeration date
01/12/2018
Last updated
03/17/2018
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