Individual
MRS. SUSAN B COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 DAWN LN, WAVERLY, OH 45690-9138
(740) 947-6306
(740) 947-6538
Mailing address
700 STATE ROUTE 551, WAVERLY, OH 45690-9699
(740) 947-4684
(740) 947-6538
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
Primary
—
OH
Other
Enumeration date
10/01/2007
Last updated
10/01/2007
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