NPI 1023734233

Cooper Ray Vance

Practitioner Peer Specialist Elizabethtown, KY

Practice location

Address: 100 Par Ln, Elizabethtown, KY 42701-9059
Phone: (270) 317-0225

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X

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Registry record

NPI: 1023734233
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Oct 2022
Record last updated: 19 Oct 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.