Healthcare Provider Details

I. General information

NPI: 1578180238
Provider Name (Legal Business Name): NISHA COPELAND DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2020
Last Update Date: 06/13/2022
Certification Date: 06/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

768 PARK MEADOW RD
WESTERVILLE OH
43081-2871
US

IV. Provider business mailing address

768 PARK MEADOW RD
WESTERVILLE OH
43081-2871
US

V. Phone/Fax

Practice location:
  • Phone: 614-392-2732
  • Fax: 614-392-2792
Mailing address:
  • Phone: 614-392-2732
  • Fax: 614-392-2792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number34852
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-05160
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: