Most Relevant Information
Provider Data
| NPI Number: | 1003199068 |
| Provider Name: | COOPER L RENDON PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 085-004146 |
Most Important Dates
| Enumeration Date: | 09/26/2011 |
| Last Updated: | 05/02/2018 |
Provider Practice Location
7635 ADDISEN PATH
INVER GROVE HEIGHTS
MN
550774108
Practice Location Phone/Fax
| Phone: | 8056988480 |
| Fax: |
Provider Mailing Location
7635 ADDISEN PATH
INVER GROVE HEIGHTS
MN
550774108
Provider Mailing Phone/Fax
| Phone: | 8056988480 |
| Fax: |