| Cooperative Therapy Llc | |
|
412 S Clay Ave Lower Level Kirkwood MO 63122-5860 | |
| (314) 914-5762 | |
| Not Available |
| Full Name | Cooperative Therapy Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 412 S Clay Ave, Kirkwood, Missouri |
| Authorized Official Name and Position | Jack Jacobsen (OWNER) |
| Authorized Official Contact | 3149145762 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cooperative Therapy Llc 412 S Clay Ave Lower Level Kirkwood MO 63122-5860 Ph: (314) 914-5762 | Cooperative Therapy Llc 412 S Clay Ave Lower Level Kirkwood MO 63122-5860 Ph: (314) 914-5762 |
| NPI Number | 1780136945 |
|---|---|
| Provider Enumeration Date | 11/03/2016 |
| Last Update Date | 11/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780136945 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2007031620 (Missouri) | Primary |
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