Individual
MRS. TARA LYNN COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
2806 HILLCREEK DR, AUGUSTA, GA 30909-6484
(706) 863-0200
(706) 863-5460
Mailing address
2806 HILLCREEK DR, AUGUSTA, GA 30909-6484
(706) 863-0200
(706) 863-5460
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
3812
GA
Other
Enumeration date
01/12/2012
Last updated
01/12/2012
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