Individual
GRAHAM COOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 HILLMONT AVE, VENTURA, CA 93003-1647
(805) 652-6729
Mailing address
200 HILLMONT AVE, VENTURA, CA 93003-1647
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
374354
CA
Other
Enumeration date
09/17/2007
Last updated
09/17/2007
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