Individual
JADE COPPERSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308
(788) 540-4686
Mailing address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2212
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
008814
GA
Other
Enumeration date
06/11/2018
Last updated
07/31/2018
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