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Individual

RICHARD COOLEY III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
100 MALTON ST, STE 4, NEGAUNEE, MI 49866-2001
(906) 475-7838
(906) 486-6898
Mailing address
100 MALTON ST, STE 4, NEGAUNEE, MI 49866-2001
(906) 475-7838
(906) 486-6898

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5101013819
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00184525
RRMEDICARE
MI
01
RC013819
BCBS LICENSE
MI
Enumeration date
12/14/2006
Last updated
07/08/2007
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