Individual
BRIAN K COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
275 11TH ST S, WAHPETON, ND 58075-4655
(701) 642-2000
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-4222
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0404
ND
363AM0700X
Medical Physician Assistant
—
ND
Other
Enumeration date
10/22/2008
Last updated
07/21/2022
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