Individual
MS. VIRGINIA CAROL COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
950 E BOGARD RD STE 103, WASILLA, AK 99654-7184
(907) 352-2820
(907) 352-2885
Mailing address
950 E BOGARD RD STE 103, WASILLA, AK 99654-7184
(907) 352-2820
(907) 352-2885
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003339
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
561080766A
—
GA
Enumeration date
08/15/2005
Last updated
12/05/2022
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