Individual
KELLY M COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1013 S TALBOT ST, SAINT MICHAELS, MD 21663-2637
(954) 298-9913
Mailing address
510 TENANT CIR, SAINT MICHAELS, MD 21663-2873
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA2775
MD
Other
Enumeration date
10/28/2020
Last updated
06/05/2023
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