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1104939685
MARY ALICE COOPER
ATLANTA, GA
NPI
1104939685
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: GA 001773)
Enumeration Date
2006-08-17
Last Update Date
2007-07-08
Business Address
MARY ALICE COOPER PA
1525 CLIFTON RD NE SUITE 207
ATLANTA, GA 30322-4200
Phone number: 404-778-4451
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Mailing Address
MARY ALICE COOPER PA
379 MILLEDGE AVE SE
ATLANTA, GA 30312-3238
Phone number: 404-577-7084
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