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MAC COOPER PTA

Individual Provider (NPI-1) Active

Physical Medicine & Rehabilitation

Provider Information

NPI Number
1831627710
Provider Type
Individual Provider (NPI-1)
Credentials
PTA
Status
Active

Contact & Location

Address
802 SHOUP ST, SALMON, ID, 834674305
Phone
(208) 756-2005
Fax
(208) 756-4020

Specialties & Taxonomies

Physical Medicine & Rehabilitation Primary License: ID #PTA5126

All Addresses

MAILING

PO BOX 1107

SALMON, ID, 834671107

(208) 756-2005

LOCATION

802 SHOUP ST

SALMON, ID, 834674305

(208) 756-2005