Individual
MR. COLLIN DALLAS COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
919 CONESTOGA RD, BLUILDING #1 SUITE# 300, BRYN MAWR, PA 19010-1352
(610) 525-6580
(610) 525-3664
Mailing address
919 CONESTOGA RD, BLUILDING #1 SUITE# 300, BRYN MAWR, PA 19010-1352
(610) 525-6580
(610) 525-3664
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA054907
PA
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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