Individual
MR. EARNEST COOPER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
166 E 1800 N, APT2, NORTH LOGAN, UT 84341-1790
(435) 881-6247
Mailing address
166 E 1800 N, APT2, NORTH LOGAN, UT 84341-1790
(435) 881-6247
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
Other
Enumeration date
12/20/2011
Last updated
12/20/2011
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