Individual
BRAINARD COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
431 WILLIAMS, COLUMBIA, SC 29208-4105
(803) 777-0452
Mailing address
431 WILLIAMS, COLUMBIA, SC 29208-4105
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
020
SC
Other
Enumeration date
06/09/2016
Last updated
06/09/2016
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