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General NPI Number Information
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NPI Number | 1912523911
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Entity Type | Individual
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Provider Name | TREVOR KOPLITZ DPT
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Gender | Male
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Dates
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Enumeration Date | 06/25/2020
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 1211 S GLOSTER ST STE C
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City | TUPELO
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State | MS
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Zip | 38801-6548
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Country | US
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Telephone | 662-432-1523
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Fax | 662-432-1528
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Provider Business Mailing Address
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Address Line | 1211 S GLOSTER ST
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City | TUPELO
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State | MS
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Zip | 38801-6546
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Country | US
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Telephone | 662-432-1523
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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 | 09675
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT7850
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License Number State | MS
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