Organization
CHANNON COOPER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANNON COOPER (OWNER)
(702) 349-2705
Entity
Organization
Contact information
Practice address
4390 E BALTIMORE AVE, LAS VEGAS, NV 89104-5304
(702) 449-3705
Mailing address
4390 E BALTIMORE AVE, LAS VEGAS, NV 89104-5304
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/05/2024
Last updated
01/05/2024
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