Organization
WANTZY COOPER ENTERPRISES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANTZY COOPER D.O. (OWNER/MEMBER MANAGER)
(917) 697-4065
Entity
Organization
Contact information
Practice address
2440 HIGHWAY 95 STE B215, BULLHEAD CITY, AZ 86442-7323
(917) 697-4065
(928) 704-1572
Mailing address
2440 HIGHWAY 95 STE B215, BULLHEAD CITY, AZ 86442-7323
(917) 697-4065
(928) 704-1572
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/03/2024
Last updated
06/03/2024
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