Copper Ridge Medical PA
NPI #1750557641 in Georgetown, Texas
Provider Information
- NPI Number
- 1750557641
- Entity Type
- Organization
- Organization Name
- Copper Ridge Medical PA
- Primary Specialty
- Clinic/Center
- Enumeration Date
- May 1, 2008
- Last Updated
- Jun 17, 2009
Practice Location
- Address
- 7600 HIGHWAY 29 W
- Address 2
- STE #5
- City
- Georgetown
- State
- Texas
- ZIP Code
- 78628-6937
- Phone
- (512) 930-0363
Authorized Official
- Name
- ANN NOLEN, D.O.
- Title
- OWNER
- Phone
- (512) 930-0363
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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