Individual
DEJA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
N91W15750 FALLS PKWY, MENOMONEE FALLS, WI 53051-2301
(262) 532-1100
Mailing address
5644 N 35TH ST, MILWAUKEE, WI 53209-4032
(414) 524-9624
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
WI
Other
Enumeration date
05/09/2019
Last updated
06/02/2023
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