MRS. Mary Lane Cooper, PA/C

NPI #1508116765 in Claxton, Georgia

Provider Information

NPI Number
1508116765
Entity Type
Individual
Name
MRS. Mary Lane Cooper, PA/C
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant - Medical
Credential
PA/C
Enumeration Date
Sep 14, 2012
Last Updated
Sep 14, 2012

Practice Location

Address
3609 BILL HODGES RD
State
Georgia
ZIP Code
30417-6235
Phone
(912) 739-4807

Specialties & Taxonomy Codes

Specialty
Physician Assistant - MedicalMedical

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