Individual
MS. COURTNEY LANE LOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1024 MAR WALT DR, FORT WALTON BEACH, FL 32547-6645
(850) 863-3148
Mailing address
1024 MAR WALT DR, FORT WALTON BEACH, FL 32547-6645
(850) 863-3148
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001001101
NC
363A00000X
Physician Assistant
PA1523
NV
363A00000X
Physician Assistant
Primary
PA9110566
FL
Other
Enumeration date
01/11/2008
Last updated
10/25/2017
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