Individual
PEGGY S COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
601 N BOEKE RD, EVANSVILLE, IN 47711-5925
(812) 477-1908
Mailing address
7112 S 1825 W, GRIFFIN, IN 47616-9306
(812) 306-6682
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06001791A
IN
Other
Enumeration date
07/17/2008
Last updated
07/17/2008
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