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Individual

DR. MADONNA RENEE COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
10300 W 103RD ST, SUITE 300, OVERLAND PARK, KS 66214-2642
(913) 894-1910
Mailing address
2946 N 77TH ST, KANSAS CITY, KS 66109-1622
(913) 334-1544

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-03309
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11-03309
STATE LICENSE
KS
Enumeration date
06/04/2008
Last updated
06/04/2008
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