Individual
ELIZABETH ANN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5800 RIDGE AVE, PHILA, PA 19128-1737
(215) 483-9900
Mailing address
400 SUTTON AVE, FOLSOM, PA 19033-1220
(610) 876-5005
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA050630
PA
Other
Enumeration date
11/02/2006
Last updated
07/08/2007
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