Individual
TARA MARIE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 W MAIN ST, ENON, OH 45323-1233
(937) 864-1603
Mailing address
6899 NEW HORIZON AVE, ENON, OH 45323-1524
(937) 245-2393
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
09316634
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09316634
CERTIFIED PHARMACY TECHNICIAN
OH
Enumeration date
04/13/2022
Last updated
04/13/2022
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