Individual
PAUL S COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1101 JUDY WAY, RIDGECREST, CA 93555-5638
(760) 446-4520
Mailing address
1101 JUDY WAY, RIDGECREST, CA 93555-5638
(760) 446-4520
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
1165
CA
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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