Individual
LAURA BETH COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
260 N MILLWARD ST, JACKSON, WY 83001-8581
(307) 699-3115
Mailing address
PO BOX 1148, JACKSON, WY 83001-1148
(901) 569-5690
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
10610A
WY
2086S0122X
Plastic and Reconstructive Surgery Physician
M-13366
ID
Other
Enumeration date
04/27/2007
Last updated
01/02/2024
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