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Individual

JACLYN KELLY COOPER-HENSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
117 MERCHANT ST, COLUMBIA, KY 42728
(270) 384-5772
(270) 380-1778
Mailing address
117 MERCHANT ST, PO BOX 861, COLUMBIA, KY 42728
(270) 384-5772
(270) 380-1778

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4655
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
85001881
KY
Enumeration date
04/20/2006
Last updated
12/12/2012
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