Individual
KENTRAL L COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1212 NE 47TH ST, OKLAHOMA CITY, OK 73111-5814
(405) 902-7098
Mailing address
1212 NE 47TH ST, OKLAHOMA CITY, OK 73111-5814
(405) 902-7098
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/19/2022
Last updated
07/19/2022
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