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Individual

MRS. SANDRA RENEE COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPSGT

Contact information

Practice address
761 TANK BATTALION, BLDG. 412, FORT HOOD, TX 76544-4906
(254) 553-7720
(254) 553-7724
Mailing address
4716 GLASS MOUNTAIN DR, KILLEEN, TX 76542-8355
(352) 321-1732

Taxonomy

Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
13706
FL

Other

Enumeration date
12/15/2015
Last updated
12/15/2015
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