Individual
MRS. CARMEN COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
218 CALVARY ST, UNIT A, WALTHAM, MA 02453-8366
(857) 919-1502
Mailing address
218 CALVARY ST, UNIT A, WALTHAM, MA 02453-8366
(857) 919-1502
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1663
MA
Other
Enumeration date
02/02/2009
Last updated
02/02/2009
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