Individual
MARY ALICE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1525 CLIFTON RD NE, SUITE 207, ATLANTA, GA 30322-4200
(404) 778-4451
(404) 778-4355
Mailing address
379 MILLEDGE AVE SE, ATLANTA, GA 30312-3238
(404) 577-7084
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001773
GA
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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