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Organization
CMG1, LLC
Active
Organization
CMG1, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN B COOPER (ADMINISTRATOR)
(877) 298-7705
Entity
Organization
Contact information
Practice address
6487 PIERCE CHAPEL RD UNIT 5, MIDLAND, GA 31820-3554
(877) 298-7705
(866) 837-9033
Mailing address
PO BOX 1611, PHENIX CITY, AL 36868-1611
(877) 298-7705
(866) 837-9033
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
56072
GA
Other
Enumeration date
06/04/2014
Last updated
06/04/2014
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