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General NPI Number Information
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NPI Number | 1124991864
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Entity Type | Individual
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Provider Name | COPLEY MARIE ALLEN MT
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Gender | Female
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 10424 HIGHWAY 44 E
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City | MOUNT WASHINGTON
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State | KY
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Zip | 40047-6319
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Country | US
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Telephone | 502-251-9191
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Fax | 502-305-2127
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Provider Business Mailing Address
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Address Line | 6912 HOLLY LAKE DR
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City | LOUISVILLE
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State | KY
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Zip | 40291-3025
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Country | US
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Telephone | 502-251-9191
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Fax | 502-305-2127
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 297131
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License Number State | KY
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