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Individual

DESTINY COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.C

Contact information

Practice address
99 CRACKER BARREL DR, SUITE 200, BARBOURSVILLE, WV 25504-1650
(304) 733-4616
(304) 733-4818
Mailing address
99 CRACKER BARREL DR, SUITE 200, BARBOURSVILLE, WV 25504-1650
(304) 733-4616
(304) 733-4818

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
951
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810026296
WV
Enumeration date
02/25/2013
Last updated
10/17/2014
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