Individual
JACOB ROY COONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
311 HAMPTON AVE, GREENWOOD, SC 29646-2204
(864) 223-7511
Mailing address
640 FAIRWAY LAKES RD, GREENWOOD, SC 29649-8435
(864) 229-6463
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4083
SC
Other
Enumeration date
03/16/2011
Last updated
03/16/2011
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