Individual
MR. RONALD OLAF COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1005 W COLUMBIA ST, W SOMERSET, KY 42503
(606) 679-1166
(606) 679-1167
Mailing address
PO BOX 3334, W SOMERSET, KY 42564
(606) 679-1166
(606) 679-1167
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3667R
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000046993
ANTHEM
—
01
—
406350766
RRMC
—
05
—
85036671
—
KY
Enumeration date
07/28/2006
Last updated
08/10/2010
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