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NPI Code Detail

MEDICARE: MRS. NADINE COPPOLA PT

MEDICARE:  MRS. NADINE  COPPOLA  PT
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 Therapist1311AZ

General Provider Information

NPI Number : 1710002522
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NADINE COPPOLA PT
Provider Business Mailing Address
First Line : 9507 N FIRERIDGE TRL
Second Line :
City : FOUNTAIN HILLS
State : AZ
Zip : 85268-5976
Country : US
Telephone Number : 480-451-0200
Fax Number : 480-451-8951
Provider Business Practice Location Address
First Line : 9507 N FIRERIDGE TRL
Second Line :
City : FOUNTAIN HILLS
State : AZ
Zip : 85268-5976
Country : US
Telephone Number : 480-451-0200
Fax Number : 480-451-8951
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 04/14/2009

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