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NPI Code Detail

MEDICARE: MICHAEL KOEPKE DPT

MEDICARE: MICHAEL KOEPKE 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 Therapist5501017127MI

General Provider Information

NPI Number : 1326548066
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL KOEPKE DPT
Provider Business Mailing Address
First Line : 10000 TELEGRAPH RD
Second Line :
City : TAYLOR
State : MI
Zip : 48180-3330
Country : US
Telephone Number : 313-438-7977
Fax Number : 313-438-7975
Provider Business Practice Location Address
First Line : 18200 OAKWOOD BLVD
Second Line :
City : DEARBORN
State : MI
Zip : 48124-5025
Country : US
Telephone Number : 313-438-7977
Fax Number : 313-438-7975
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2018
Last Update Date : 07/18/2023

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