Organization
KOOP FAMILY PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHELLE LEE SHINE KOOP DPT (MEMBER OF LLC)
(419) 471-0400
Entity
Organization
Contact information
Practice address
4859 W SYLVANIA AVE STE A, TOLEDO, OH 43623-3372
(419) 471-0400
(419) 471-0403
Mailing address
4859 W SYLVANIA AVE STE A, TOLEDO, OH 43623-3372
(419) 471-0400
(419) 471-0403
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
009627
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2714094
—
OH
Enumeration date
10/13/2006
Last updated
11/30/2022
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