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Individual

JEAN A MCCONNELL-COPPLOE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
755 BOARDMAN CANFIELD RD, BLDG F, UNIT 2, BOARDMAN, OH 44512
(330) 480-9362
(330) 480-9407
Mailing address
755 BOARDMAN CANFIELD RD, BLDG F, UNIT 2, BOARDMAN, OH 44512
(330) 480-9362
(330) 480-9407

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT10021
OH
225100000X
Physical Therapist
PT10021
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2384647
OH
Enumeration date
02/23/2006
Last updated
10/29/2024
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