Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand | R0606 | MO |
NPI | 1154355089 |
---|---|
Provider Name | Norma Ann Coplin |
First Address | Saint Louis, MO 63122-1253 |
Second Address | Saint Louis, MO 63128-3442 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 13/08/2010 |