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General NPI Number Information
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NPI Number | 1497769806
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Entity Type | Individual
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Provider Name | RONALD OLAF COOPER DC
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 08/10/2010
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Provider Practice Location Address
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Address Line | 1005 W COLUMBIA ST
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City | W SOMERSET
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State | KY
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Zip | 42503
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Country | US
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Telephone | 606-679-1166
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Fax | 606-679-1167
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Provider Business Mailing Address
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Address Line | PO BOX 3334
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City | W SOMERSET
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State | KY
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Zip | 42564
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Country | US
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Telephone | 606-679-1166
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Fax | 606-679-1167
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3667R
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License Number State | KY
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