Individual
MICHELLE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11984 WENDT RD, KENDRICK, ID 83537-5047
(509) 552-6605
Mailing address
11984 WENDT RD, KENDRICK, ID 83537-5047
(509) 552-6605
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
WA
Other
Enumeration date
03/19/2016
Last updated
03/19/2016
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