Organization
BEYOND THE BODY WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEDRA D COOP NP (NP/PRESIDENT)
(765) 432-7195
Entity
Organization
Contact information
Practice address
1121 HOMESTEAD RD N STE 279, LEHIGH ACRES, FL 33936-6038
(765) 432-7195
Mailing address
1121 HOMESTEAD RD N STE 279, LEHIGH ACRES, FL 33936-6038
(765) 432-7195
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/14/2022
Last updated
03/14/2022
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