Individual
RAPHAEL COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2320 E 93RD ST, CHICAGO, IL 60617-3909
(773) 967-5221
(708) 938-5239
Mailing address
2320 E 93RD ST, CHICAGO, IL 60617-3909
(773) 967-5221
(708) 938-5239
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006704
IL
Other
Enumeration date
04/15/2014
Last updated
10/25/2024
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