Individual
MR. ORRIN ANTON COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7505 ELMWOOD AVE, PHILADELPHIA, PA 19153-1312
(215) 365-7414
(215) 365-7414
Mailing address
7505 ELMWOOD AVE, PHILADELPHIA, PA 19153-1312
(215) 365-7414
(215) 365-7414
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
23533443
PA
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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