Organization
KELLY COOPER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY COOPER M.S. CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(320) 293-7827
Entity
Organization
Contact information
Practice address
1300 W MEDICINE LAKE DR, #321, PLYMOUTH, MN 55441-4859
(320) 293-7827
Mailing address
1300 W MEDICINE LAKE DR, #321, PLYMOUTH, MN 55441-4859
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9027
MN
Other
Enumeration date
12/18/2013
Last updated
12/18/2013
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