Individual
CHRISTINE POWERS KOOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2104 WOODRUFF RD, GREENVILLE, SC 29607-5941
(864) 676-1072
(864) 676-0729
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6303
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1888
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085001153
—
IL
05
—
1573PA
—
SC
Enumeration date
06/21/2005
Last updated
02/01/2018
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