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Individual

LANCE COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
997 PATTON LN, ASHLAND, OR 97520-9135
(541) 941-5170
(541) 878-8111
Mailing address
108 E HERSEY ST STE 1, ASHLAND, OR 97520-1363
(541) 482-5525
(541) 708-5652

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5130
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
242029
OR
Enumeration date
01/16/2007
Last updated
04/21/2022
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