Individual
IAN THOMAS KOPRIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
4141 5TH ST, RAPID CITY, SD 57701-6021
(605) 399-9565
(605) 399-9584
Mailing address
4141 5TH ST, RAPID CITY, SD 57701-6021
(605) 399-9565
(605) 399-9584
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1845
SD
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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