Individual
BRIAN COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 NW 99TH AVE, PEMBROKE PINES, FL 33024-4345
(954) 243-8843
Mailing address
1300 NW 99TH AVE, PEMBROKE PINES, FL 33024-4345
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A01985
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A01985
MARYLAND LICENSE
MD
Enumeration date
02/22/2013
Last updated
02/22/2013
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