Individual
VICKIE LEE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
2607 N GRANDVIEW BLVD, SUITE 125, WAUKESHA, WI 53188-1686
(262) 548-0544
Mailing address
414 NORTHVIEW TRL, HARTFORD, WI 53027-1992
(262) 670-8335
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
324-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40440200
—
WI
Enumeration date
09/25/2006
Last updated
07/08/2007
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