Individual
KIMMY SUE-VANDIVER COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 N CHOCTAW AVE, SUITE 140, EL RENO, OK 73036-2624
(405) 262-3209
(405) 262-1331
Mailing address
400 S RANCHWOOD BLVD, TRLR 92, YUKON, OK 73099-2731
(405) 262-3209
(405) 262-1331
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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