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Organization
OLD DOMINION UNIVERSITY
Active
Organization
OLD DOMINION UNIVERSITY
Active
Parent organization
OLD DOMINION UNIVERSITY
Other names
ODU Monarch Physical Therapy
Organization subpart
Yes
Provider details
NPI number
Legal business name
OLD DOMINION UNIVERSITY
Authorized official
LISA R KOPERNA DPT (CLINIC DIRECTOR)
(757) 683-7041
Entity
Organization
Contact information
Practice address
1019 W 41ST ST, NORFOLK, VA 23529-0001
(757) 683-7041
(757) 683-4410
Mailing address
1019 W 41ST ST, NORFOLK, VA 23529-0001
(757) 683-7041
(757) 683-4410
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/24/2013
Last updated
09/02/2025
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