Individual
REGINALD W COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1055 S HOUSTON AVE, TULSA, OK 74127-9043
(918) 921-3200
Mailing address
PO BOX 691619, TULSA, OK 74169-1619
(405) 501-2557
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
72555
OK
Other
Enumeration date
09/06/2017
Last updated
09/06/2017
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