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General NPI Number Information
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NPI Number | 1487918090
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Entity Type | Individual
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Provider Name | BRIAN COOPER L.AC.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2012
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 3516 S 9TH ST UNIT E
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City | TACOMA
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State | WA
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Zip | 98405-2227
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Country | US
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Telephone | 281-901-0812
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7734
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City | TACOMA
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State | WA
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Zip | 98417-0734
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 60440314
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License Number State | WA
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