Individual
MICHELLE A COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
801 S ADAMS ST, PETERSBURG, VA 23803-5149
(804) 862-5000
Mailing address
13916 HOWLETT LINE DR, COLONIAL HEIGHTS, VA 23834-5865
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110840698
VA
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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