Individual
BETHANY DAWN COPPOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4725 COLONIAL OAKS DRIVE, MARION, IN 46953
(765) 674-9791
Mailing address
802 S BARCLAY ST, FAIRMOUNT, IN 46928
(765) 251-1531
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001358A
IN
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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