Individual
MR. MARK W COOPER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1103 VILLAGE SQUARE DR, SUITE 100, PERRYSBURG, OH 43551-1783
(419) 874-8745
(419) 874-8748
Mailing address
1103 VILLAGE SQUARE DR, SUITE 100, PERRYSBURG, OH 43551-1783
(419) 874-8745
(419) 874-8748
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3895
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0608631
—
OH
Enumeration date
07/29/2005
Last updated
07/08/2007
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