Individual
JUSTIN M. COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
502 54TH AVE E, FIFE, WA 98424-2724
(253) 459-7500
Mailing address
502 54TH AVE E, FIFE, WA 98424-2724
(253) 459-7500
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
2005019083
MO
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OP60075152
WA
Other
Enumeration date
04/06/2007
Last updated
05/04/2015
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