Individual
MR. JONATHAN ROBERT KOPKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
673 WYOMING AVE APT C, KINGSTON, PA 18704-3862
(570) 709-1509
Mailing address
673 WYOMING AVE APT C, KINGSTON, PA 18704-3862
(570) 709-1509
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN549838
PA
Other
Enumeration date
07/27/2012
Last updated
07/27/2012
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