Individual
JAMIE ATHELA COOPER-BRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13846 STATE ROUTE 613, VAN BUREN, OH 45889-9715
(419) 889-5217
Mailing address
13846 STATE ROUTE 613, VAN BUREN, OH 45889-9715
(419) 889-5217
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
3202635
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3202635
—
OH
Enumeration date
02/23/2021
Last updated
02/23/2021
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