Individual
COLETTE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
602 SE WALLOCK ST, LAWTON, OK 73501-5403
(580) 585-5577
Mailing address
602 SE WALLOCK ST, LAWTON, OK 73501-5403
(580) 585-5577
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1883
OK
Other
Enumeration date
05/26/2011
Last updated
05/26/2011
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