Jackie Cooper

NPI #1013425941 in Fort Collins, Colorado

Provider Information

NPI Number: 1013425941
Entity Type: Individual
Name: Jackie Cooper
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Jan 12, 2018
Last Updated: Mar 17, 2018

Practice Location

Address: 3938 JOHN F KENNEDY PKWY UNIT 11C
City: Fort Collins
State: Colorado
ZIP Code: 80525-3087
Phone: (970) 227-6184

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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