Individual provider · Type 1 NPI

Detrick Mark Cooter

Specialist · Phoenix, AZ

NPI number 1295560688 Active

Practice location

406 E Mclellan Blvd
Phoenix, AZ 85012-1038

Call (505) 620-3864 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XCSP40000064 (DC)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1295560688

Detrick Mark Cooter's National Provider Identifier is 1295560688, issued on Sep 4, 2024. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Phoenix, AZ. The record was last updated on Sep 4, 2024.