Individual
HOLLY JANE COPENHAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
525 N SANTIAM HWY, LEBANON, OR 97355-4363
(541) 451-7125
Mailing address
73 GRACE ST, LEBANON, OR 97355-4600
(503) 882-4384
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5758
OR
Other
Enumeration date
10/06/2008
Last updated
09/02/2009
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