Individual
AUSTIN JOHN COPPOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
4901 LAC DE VILLE BLVD, ROCHESTER, NY 14618-5647
(585) 341-9200
Mailing address
45 PRINCETON LN, FAIRPORT, NY 14450-9026
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
046031
NY
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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