Individual
ELISA COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 PARK AVE, COLLEGEVILLE, PA 19426-2629
(610) 409-2604
Mailing address
55 PARK AVE, COLLEGEVILLE, PA 19426-2629
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP443994
PA
Other
Enumeration date
01/28/2021
Last updated
01/28/2021
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