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General NPI Number Information
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NPI Number | 1780097154
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Entity Type | Individual
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Provider Name | BREANNE MARIE COPE
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Gender | Female
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 1630 E HERNDON AVE
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City | FRESNO
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State | CA
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Zip | 93720-3391
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Country | US
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Telephone | 559-256-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 5055 CALIFORNIA AVE SUITE 210
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0701
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Country | US
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Telephone |
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 39970
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License Number State | CA
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