Individual
JACK COOPER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
1650 COCHRANE CIR, USA MEDDAC/EACH ATTN MS. RANKIN, FT CARSON, CO 80913-4603
(719) 526-7649
Mailing address
1650 COCHRANE CIR, USA MEDDAC/EACH ATTN MS. RANKIN, FT CARSON, CO 80913-4603
(719) 526-7649
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
126738
CO
Other
Enumeration date
02/27/2006
Last updated
07/08/2007
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