Provider Demographics
NPI:1992554869
Name:HARDIN, COOPER (HIS)
Entity type:Individual
Prefix:
First Name:COOPER
Middle Name:
Last Name:HARDIN
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8015 W ALAMEDA AVE STE G-30
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-3041
Mailing Address - Country:US
Mailing Address - Phone:303-936-9774
Mailing Address - Fax:
Practice Address - Street 1:8015 W ALAMEDA AVE STE G-30
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3041
Practice Address - Country:US
Practice Address - Phone:303-936-9774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000544237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist