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Individual

HALEY ANNE KOPPENHAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
76 REHAB LN, DANVILLE, PA 17822-0001
(570) 271-6110
Mailing address
1018 TREVORTON RD, COAL TOWNSHIP, PA 17866-7706

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI005631
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0094
PA
Enumeration date
08/04/2021
Last updated
08/04/2021
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