Organization
DR. MICHELLE M. COOPER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE COOPER O.D. (PRESIDENT)
(864) 901-5751
Entity
Organization
Contact information
Practice address
24 POTOMAC AVE, GREENVILLE, SC 29605-2118
(864) 277-4420
Mailing address
24 POTOMAC AVE, GREENVILLE, SC 29605-2118
(864) 277-4420
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1038
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D10389
—
SC
Enumeration date
10/07/2015
Last updated
10/07/2015
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