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NPI Code Detail

MEDICARE: HEATHER KOOPMAN DPT

MEDICARE: HEATHER KOOPMAN DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistP16484NC

General Provider Information

NPI Number : 1073069795
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER KOOPMAN DPT
Provider Business Mailing Address
First Line : 2000 BRABHAM AVE STE 100
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-0202
Country : US
Telephone Number : 910-332-3800
Fax Number : 910-251-0421
Provider Business Practice Location Address
First Line : 2000 BRABHAM AVE STE 100
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-0202
Country : US
Telephone Number : 910-332-3800
Fax Number : 910-251-0421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2016
Last Update Date : 10/19/2020

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Directions to “ HEATHER KOOPMAN DPT” Practice Location

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