Provider Demographics
NPI:1891550943
Name:COPACK, BRITTANY (CPT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:COPACK
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1409
Mailing Address - Street 2:
Mailing Address - City:LADSON
Mailing Address - State:SC
Mailing Address - Zip Code:29456-1409
Mailing Address - Country:US
Mailing Address - Phone:708-731-0740
Mailing Address - Fax:
Practice Address - Street 1:105 HICKORY LN UNIT A
Practice Address - Street 2:
Practice Address - City:LADSON
Practice Address - State:SC
Practice Address - Zip Code:29456-5914
Practice Address - Country:US
Practice Address - Phone:708-731-0740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy