Organization
DM COOPER, DPM & ASSOCIATES, DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIREESE MARY COOPER DPM (PODIATRIST)
(267) 972-9992
Entity
Organization
Contact information
Practice address
2621 W 9TH ST, CHESTER, PA 19013-2115
(267) 972-9992
(267) 385-5022
Mailing address
8603 GILBERT ST, PHILADELPHIA, PA 19150-2703
(267) 972-9992
(267) 385-5022
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
SC003585R
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001232500000
—
PA
Enumeration date
04/27/2010
Last updated
04/27/2010
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