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Individual

MR. KIERSTON COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, LAT, ATC

Contact information

Practice address
7822 SNOWFLAKE DR, INDIANAPOLIS, IN 46227-8077
(502) 741-6856
Mailing address
7822 SNOWFLAKE DR, INDIANAPOLIS, IN 46227-8077
(502) 741-6856

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002401A
IN

Other

Enumeration date
01/05/2021
Last updated
01/05/2021
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