Organization
SOUTH ATLANTA MUA CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN B COOPER DC (SOLE MEMBER)
(855) 880-7568
Entity
Organization
Contact information
Practice address
541 FOREST PKWY, STE 14, FOREST PARK, GA 30297-6144
(855) 880-7568
(866) 837-9033
Mailing address
P.O. BOX 1601, PHENIX CITY, AL 36867
(855) 880-7568
(866) 837-9033
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
031143
GA
Other
Enumeration date
09/23/2014
Last updated
05/07/2015
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