Organization
EAST COOPER PHYSICIAN GROUP LLC
Active
Other names
Revela Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
DOREATHA ROGERS (RCS MANAGER)
(980) 302-7992
Entity
Organization
Contact information
Practice address
1047 ANNA KNAPP BLVD, MT PLEASANT, SC 29464-3146
(843) 884-7977
Mailing address
PO BOX 37642, BELFAST, ME 04915-1218
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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