Individual
MRS. CHARITA NICOLE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
16705 SQUARE DR, MARYSVILLE, OH 43040-8722
(937) 642-4400
(937) 642-4443
Mailing address
16705 SQUARE DR, MARYSVILLE, OH 43040-8476
(937) 642-4400
(937) 642-4443
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3186
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2326049
—
OH
Enumeration date
07/06/2006
Last updated
04/05/2013
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