Individual
JADE VICTORIA COPPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
605 E FRANKLIN ST, HARTWELL, GA 30643-7301
(706) 376-6200
(706) 376-6488
Mailing address
17 CARTER RUN CT, SIMPSONVILLE, SC 29681-6573
(203) 214-0453
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
9274
GA
Other
Enumeration date
11/04/2018
Last updated
07/05/2019
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