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Individual

DR. BRIAN C COPPLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
311 U.S. HWY 2, SULTAN, WA 98294
(360) 793-1122
(360) 793-1012
Mailing address
PO BOX 1425, SULTAN, WA 98294-1425

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00001871
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
538488529-01
CIGNA
WA
01
85721
WORKERS COMP
WA
01
CH00001871
CHIRO LICENSE NUMBER
WA
01
R76506
REGENCE
WA
Enumeration date
11/21/2006
Last updated
07/08/2007
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