Individual
RUSSELL KOPPIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
21700 NORTHWESTERN HWY, SOUTHFIELD, MI 48075-4906
(313) 600-8563
Mailing address
21700 NORTHWESTERN HWY, SOUTHFIELD, MI 48075-4906
(313) 600-8563
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009780
MI
Other
Enumeration date
02/26/2018
Last updated
06/23/2021
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