Individual
EVA COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1024 US HIGHWAY 80 W, STE 206, POOLER, GA 31322-2188
(912) 342-3036
Mailing address
40 PENNINGTON DR, UNIT D, BLUFFTON, SC 29910-6053
(843) 227-1410
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
90240
SC
Other
Enumeration date
09/08/2011
Last updated
07/26/2021
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