Individual
ZACHARY DANIEL KOPACZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
W4874 EDELWEISS RD, NEW GLARUS, WI 53574-9304
(608) 424-8735
Mailing address
W4874 EDELWEISS RD, NEW GLARUS, WI 53574-9304
(608) 424-8735
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
WI
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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