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Individual

THERESA MARY COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CFA, CSA

Contact information

Practice address
1901 TATE SPRINGS RD, LGH OR, LYNCHBURG, VA 24501-1109
(434) 200-3015
Mailing address
129 WELLINGTON DR, LYNCHBURG, VA 24502-2529
(434) 237-7998

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
363AS0400X
Surgical Physician Assistant

Other

Enumeration date
05/26/2008
Last updated
07/12/2009
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