Individual
GRACE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3900 BETHEL DR, SAINT PAUL, MN 55112-6902
(763) 218-8589
Mailing address
3900 BETHEL DR, SAINT PAUL, MN 55112-6902
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/20/2016
Last updated
04/20/2016
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