Individual
MARCIA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2158 LADEN RD, MELBOURNE, FL 32935-3035
(321) 259-0582
Mailing address
2158 LADEN RD, MELBOURNE, FL 32935-3035
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 431561
FL
Other
Enumeration date
12/10/2007
Last updated
12/10/2007
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