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General NPI Number Information
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NPI Number | 1982838876
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Entity Type | Individual
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Provider Name | JENNIFER MARIE COOPER B.S.
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Gender | Female
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Dates
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Enumeration Date | 05/07/2009
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Last Update Date | 05/07/2009
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Provider Practice Location Address
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Address Line | 1800 RENAISSANCE BLVD
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City | EDMOND
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State | OK
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Zip | 73013-3023
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Country | US
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Telephone | 405-359-2472
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Fax |
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Provider Business Mailing Address
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Address Line | 1112 NW 34TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73118-5613
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Country | US
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Telephone | 405-664-6612
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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