Courtney Cooper
Mastectomy Fitter in Winston Salem, NC. Individual provider (NPI-1).
NPI number1972235752
StatusActive
Last updated in NPPESJun 29, 2022
Details
- NPI
- 1972235752
- Entity type
- Individual (NPI-1)
- Name
- Courtney Cooper
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 29, 2022
- Certification date
- Jun 29, 2022
- Last updated
- Jun 29, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224900000X | Mastectomy Fitter | C54085 | NC | Yes |
| 225000000X | Orthotic Fitter | C54085 | NC |
Practice location
2200 Silas Creek PkwyWinston Salem, NC 27103-5000
Phone 336-760-4333
Mailing address
2200 Silas Creek PkwyWinston Salem, NC 27103-5000
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