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Individual

REBECCA KOOPMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
818 E BROADWAY ST, SPARTA, IL 62286-1820
(618) 443-2177
Mailing address
1016 ALAN DR, RED BUD, IL 62278-1403
(618) 978-3812

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
07/06/2017
Last updated
07/06/2017
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