Individual
DR. JON H COOPERRIDER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
484 PARK AVE W, MANSFIELD, OH 44906-3118
(419) 525-0330
(419) 525-3362
Mailing address
484 PARK AVE W, MANSFIELD, OH 44906-3118
(419) 525-0330
(419) 525-3362
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4014/T214
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0893332
—
OH
Enumeration date
09/23/2005
Last updated
03/11/2008
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