Individual
MR. TIMOTHY LEE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
105 CHURCH, BOX 40, CONRAD, IA 50621-0040
(641) 366-2123
(641) 366-2143
Mailing address
105 CHURCH STREET, BOX 40, CONRAD, IA 50621
(641) 366-2123
(641) 366-2143
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001336
IA
Other
Enumeration date
12/08/2005
Last updated
07/05/2022
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