Individual
KELLY MARIE KOPKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2501 W 12TH ST STE C10, ERIE, PA 16505-4527
(814) 580-5600
(814) 455-2584
Mailing address
2501 W 12TH ST STE C10, ERIE, PA 16505-4527
(814) 580-5600
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS013485
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002052642
HIGHMARK BCBS
PA
05
—
1026864670001
—
PA
Enumeration date
09/11/2007
Last updated
12/04/2020
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