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1518157544
STACY COOPER
BLACKFOOT, ID
NPI
1518157544
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: ID PA648)
Enumeration Date
2007-07-26
Last Update Date
2009-05-01
Business Address
Mrs. STACY COOPER PA-C
98 POPLAR ST
BLACKFOOT, ID 83221-1758
Phone number: 208-785-4100
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Mailing Address
Mrs. STACY COOPER PA-C
98 POPLAR ST
BLACKFOOT, ID 83221-1758
Phone number: 208-785-4100
Copy
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