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Individual

JACOB COOLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7840 WASHINGTON AVE, KANSAS CITY, KS 66112-2152
(913) 328-4600
Mailing address
7840 WASHINGTON AVE, KANSAS CITY, KS 66112-2152
(913) 328-4600

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
05131
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30003913810001
KS
Enumeration date
04/13/2026
Last updated
04/15/2026
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