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Individual

BRIAN DAVID COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CMT/LMT

Contact information

Practice address
7450 HERITAGE VILLAGE PLZ, SUITE 201, GAINESVILLE, VA 20155-3090
(973) 800-5194
Mailing address
9272 CALADIUM DR, MANASSAS, VA 20110-6083
(973) 800-5194

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
0019009629
VA
172M00000X
Mechanotherapist
MT1634
DC

Other

Enumeration date
11/16/2012
Last updated
07/10/2013
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