Individual
MS. MALIA RENEE KOPPIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
77 GORE ST, CAMBRIDGE, MA 02141-1213
(937) 726-7222
Mailing address
77 GORE ST, CAMBRIDGE, MA 02141-1213
(937) 726-7222
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
18876
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RY829499
DRIVER'S LICENSE
OH
Enumeration date
11/19/2009
Last updated
06/14/2011
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