Individual
JOSHUA KOOPMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 333-3311
Mailing address
611 W. PARK, FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085009125
IL
363A00000X
Physician Assistant
PA60909354
WA
363AM0700X
Medical Physician Assistant
PA60909354
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2115074
—
WA
Enumeration date
09/10/2017
Last updated
12/12/2022
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