Healthcare Provider Details

I. General information

NPI: 1154438018
Provider Name (Legal Business Name): THOMAS KOPSCH DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 S OLD WOODWARD AVE
BIRMINGHAM MI
48009-6600
US

IV. Provider business mailing address

32268 WOODWARD AVE
ROYAL OAK MI
48073-0944
US

V. Phone/Fax

Practice location:
  • Phone: 248-792-6570
  • Fax: 248-792-6574
Mailing address:
  • Phone: 248-549-0140
  • Fax: 248-549-5665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberTK005961
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: