Individual
MR. JOHN W COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.A.S., L.D.
Contact information
Practice address
3949 SHASTA WAY, KLAMATH FALLS, OR 97603
(541) 884-0292
(884) 619-2541
Mailing address
3949 SHASTA WAY, KLAMATH FALLS, OR 97603
(541) 884-0292
(541) 884-6192
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DT-D-0501891
OR
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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