Individual
MS. DEIRDRE LEA COPPAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7501 HERITAGE VILLAGE PLZ, GAINESVILLE, VA 20155-3078
(571) 248-6199
Mailing address
7501 HERITAGE VILLAGE PLZ, GAINESVILLE, VA 20155-3078
(571) 248-6199
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602913
VA
Other
Enumeration date
01/05/2011
Last updated
01/05/2011
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