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Individual

MR. MICHAEL JOHN KOP

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
RDMS

Contact information

Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6020
(505) 368-6431
Mailing address
PO BOX 160, SIPROCK, NM 87420
(505) 368-6020
(505) 368-6431

Taxonomy

Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
26917

Other

Enumeration date
11/21/2005
Last updated
07/08/2007
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