Individual
MRS. MAKEDA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN,WCC
Contact information
Practice address
2250 HICKORY RD, SUITE240, PLYMOUTH MEETING, PA 19462-1047
(610) 834-1122
Mailing address
2463 76TH AVE, PHILADELPHIA, PA 19150-1807
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN253429L
PA
Other
Enumeration date
11/29/2007
Last updated
11/29/2007
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