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General NPI Number Information
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NPI Number | 1962612309
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Entity Type | Individual
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Provider Name | DIANE COPELAND D.C.
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 763 UNIVERSITY BLVD N
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City | JACKSONVILLE
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State | FL
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Zip | 32211-5527
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Country | US
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Telephone | 904-704-3309
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2928
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City | PALM BEACH
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State | FL
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Zip | 33480-2928
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Country | US
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Telephone | 561-655-1747
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2651
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License Number State | FL
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