Healthcare Provider Details

I. General information

NPI: 1134940398
Provider Name (Legal Business Name): ZACKERY KOPPING DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ZACK KOPPING DC

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13832 N 32ND ST BLDG B112
PHOENIX AZ
85032-5613
US

IV. Provider business mailing address

14560 W GREENWAY RD APT 1026
SURPRISE AZ
85374-0021
US

V. Phone/Fax

Practice location:
  • Phone: 480-335-4878
  • Fax:
Mailing address:
  • Phone: 509-460-2927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9323
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: