Individual
MAGEN COPHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 ROACH ST, GEORGETOWN, KY 40324-9393
(502) 863-4734
Mailing address
1351 NEWTOWN PIKE BLDG 1, LEXINGTON, KY 40511-1277
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
08/28/2018
Last updated
08/28/2018
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