Individual
TOMMY COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1617 E ELECTRIC AVE, MCALESTER, OK 74501-3864
(918) 424-1496
Mailing address
3884 BUCKS OF GAINS CREEK RD, MCALESTER, OK 74501-7597
(918) 424-1496
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
189580
OK
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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