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Organization

RON L KOPITZKE PT, DPT OCS

Active
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Organization

RON L KOPITZKE PT, DPT OCS

Active
Other names
Sierra Orthopaedic & Athletic Rehabilitation
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RON L KOPITZKE PT DPT OCS (OWNER)
(530) 344-2045
Entity
Organization

Contact information

Practice address
4300 GOLDEN CENTER DR, SUITE B, PLACERVILLE, CA 95667-6278
(530) 344-2045
(530) 642-0794
Mailing address
4300 GOLDEN CENTER DR STE B, PLACERVILLE, CA 95667
(530) 344-2045
(530) 642-0794

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT106430
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPT106430
PTAN
—
Enumeration date
08/08/2006
Last updated
07/25/2008
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