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Individual

MICHAEL COOPER JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2053 GAUSE BLVD E, SLIDELL, LA 70461-5449
(985) 290-1619
Mailing address
2053 GAUSE BLVD E, SLIDELL, LA 70461-5449

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
009332998
LA

Other

Enumeration date
11/11/2015
Last updated
11/11/2015
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