Individual
KALLIE DANIELE VAN COPPENOLLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
339 OPAL CT, STREETSBORO, OH 44241-4147
(330) 780-1369
Mailing address
339 OPAL CT, STREETSBORO, OH 44241-4147
(330) 780-1369
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/25/2019
Last updated
09/11/2025
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