Most Relevant Information
Provider Data
| NPI Number: | 1003582206 |
| Provider Name: | TARA MARIE KOPER |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 149136 |
Most Important Dates
| Enumeration Date: | 08/18/2021 |
| Last Updated: | 08/18/2021 |
Provider Practice Location
823 HALLOCK YOUNG RD SW
WARREN
OH
444818670
Practice Location Phone/Fax
| Phone: | 3303605443 |
| Fax: |
Provider Mailing Location
823 HALLOCK YOUNG RD SW
WARREN
OH
444818670
Provider Mailing Phone/Fax
| Phone: | 3303605443 |
| Fax: |