Individual
MRS. JILL DANIELLE KOPENY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
777 CORPORATE DR, STE 160, LADERA RANCH, CA 92694-2135
(949) 472-2242
Mailing address
9 MISSION ST, RANCHO SANTA MARGARITA, CA 92688-3103
(949) 635-9788
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5590
CA
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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