Individual
AMY LYNN KOUTSOPOULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
361 E 45TH ST, LORAIN, OH 44052-5505
(440) 233-8180
Mailing address
219 PARK MEADOW LN APT I, ELYRIA, OH 44035-7354
(440) 506-5255
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
121015
OH
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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