NPI 1235788621

Jonathan Kyle Cooper

Practitioner Private Vehicle Fredericksburg, VA

Practice location

Address: 2312 Drake Ln, Fredericksburg, VA 22408-0300
Phone: (703) 462-4453

Registered specialties (2)

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X

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Driver

Other Service Providers Taxonomy 172A00000X Licence A66179172 (VA)

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Registry record

NPI: 1235788621
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Sep 2019
Record last updated: 9 Sep 2019

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.