Individual
DR. CONSTANCE S COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD, PHD
Contact information
Practice address
8038 MACINTOSH LN, ROCKFORD, IL 61107-5336
(815) 332-6800
(815) 332-6810
Mailing address
8038 MACINTOSH LN, ROCKFORD, IL 61107-5336
(815) 332-6800
(815) 332-6810
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046011082
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38603100
—
WI
05
—
38723000
—
WI
Enumeration date
11/02/2005
Last updated
03/07/2024
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