Individual
COOPER LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 S NATIONAL AVE # PROF160, SPRINGFIELD, MO 65897-0001
(417) 836-5000
Mailing address
1132 SE 60TH ST, LAREDO, MO 64652-8140
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/30/2024
Last updated
05/30/2024
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