Individual
BRYAN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 W IRONWOOD DR STE 159, COEUR D ALENE, ID 83814-4401
(208) 625-3190
Mailing address
700 W IRONWOOD DR STE 159, COEUR D ALENE, ID 83814-4401
(208) 625-3190
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7329
ID
183500000X
Pharmacist
PH61499220
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS39638
IDAHO CONTROLLED SUBSTANCE REGISTRATION
ID
Enumeration date
07/23/2015
Last updated
12/01/2025
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