Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | OD3274 | TN |
Y | 152W00000X | Optometrist | OPC4609 | FL |
NPI | 1013297910 |
---|---|
Provider Name | Erin Swichkow Cooper |
First Address | Zephyrhills, FL 33542-7505 |
Second Address | Tampa, FL 33613-4931 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2011 |
Last Update Date | 13/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q023205 | (05) | TN |