Individual
COURTNEY ANN COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
112 W CLEMENT ST, DE SOTO, MO 63020-2102
(314) 580-8878
Mailing address
112 W CLEMENT ST, DE SOTO, MO 63020-2102
(314) 580-8878
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2016025013
MO
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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