Individual
COURTNEY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-5000
(336) 760-4333
Mailing address
2200 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-5000
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
C54085
NC
225000000X
Orthotic Fitter
C54085
NC
Other
Enumeration date
06/29/2022
Last updated
06/29/2022
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