Healthcare Provider Details

I. General information

NPI: 1629243787
Provider Name (Legal Business Name): TOM KOPSCH & ASSOCIATES,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17600 W 11 MILE RD STE 1
LATHRUP VILLAGE MI
48076-4722
US

IV. Provider business mailing address

17600 W 11 MILE RD STE 1
LATHRUP VILLAGE MI
48076-4722
US

V. Phone/Fax

Practice location:
  • Phone: 248-792-9736
  • Fax: 248-593-3181
Mailing address:
  • Phone: 248-792-9736
  • Fax: 248-593-3181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. TOM KOPSCH
Title or Position: OWNER
Credential:
Phone: 248-792-9736