Healthcare Provider Details

I. General information

NPI: 1871639310
Provider Name (Legal Business Name): KARA S KOEPLIN OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6030 PLUM DR
WILLIAMSBURG MI
49690-9425
US

IV. Provider business mailing address

6030 PLUM DR
WILLIAMSBURG MI
49690-9425
US

V. Phone/Fax

Practice location:
  • Phone: 231-941-3100
  • Fax: 231-922-0382
Mailing address:
  • Phone: 231-883-9822
  • Fax: 231-264-0268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201006276
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: