Individual
MR. DEREK JOSEPH KOPP I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1734 CALDWELL RD, IMLAY CITY, MI 48444-9409
(810) 417-4202
Mailing address
1734 CALDWELL RD, IMLAY CITY, MI 48444-9409
(810) 417-4202
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/12/2015
Last updated
03/12/2015
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