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Individual

CARL WESLEY COOPER SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
15681 N US HIGHWAY 301, CITRA, FL 32113-3154
(352) 595-5000
Mailing address
4604 SW 65TH PL, OCALA, FL 34474-9547
(561) 385-0832

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
05/30/2023
Last updated
05/30/2023
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