Jason Andre Cooper ATC, PTA

NPI 1356457576 - Specialist/Technologist - 2255A2300X

NPI Details
NPI 1356457576
Gender Male
Enumeration Date 08/21/2006
Last Updated 02/19/2014
Entity Type Individual
Active Over 10 years ago
Practice Location
214 EAST MAIN ST.
SENATOBIA MS, 38668, US
Phone (662) 560-0602
Fax (662) 560-0603
Business Location
20 S. MAIN STREET
WATER VALLEY MS, 38965, US
Phone (662) 473-3400
Fax (662) 473-4389
Toxanomy
Taxonomy Code 2255A2300X
License State Mississippi
License Number AT0326
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According to our database, Mr. Jason Andre Cooper ATC, PTA NPI is 1356457576, taxonomy code is 2255A2300X and license number is AT0326, license state is located at Mississippi. Jason Andre Cooper ATC, PTA physically located at 214 East Main St., Senatobia MS, 38668. NPI Number Jason Andre Cooper ATC, PTA has the Individual type.

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1356457576 NPI number is provided on an as is basis without warranty of any kind. 1356457576 is maintained by the National Plan & Provider Enumeration System. The contents of Jason Andre Cooper ATC, PTA are for informational purposes only.