Individual
JASON GEORGE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5319 S 108TH ST # 11, HALES CORNERS, WI 53130-1332
(414) 881-5976
Mailing address
8835 S OAK PARK DR APT 12, OAK CREEK, WI 53154-3814
(414) 881-5976
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10683-146
WI
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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