Individual
DR. TERESA T COOPERRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
637 N UNION ST, LOUDONVILLE, OH 44842-1074
(419) 994-4287
(419) 994-2612
Mailing address
637 N UNION ST, LOUDONVILLE, OH 44842-1074
(419) 994-4287
(419) 994-2612
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4055/T215
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0893323
—
OH
Enumeration date
09/21/2005
Last updated
03/27/2008
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