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Individual

MRS. JOAN COPELAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTA

Contact information

Practice address
105 S 6TH ST, PACIFIC, MO 63069-1328
(636) 271-4222
Mailing address
7295 HIGHWAY HH, CATAWISSA, MO 63015-1296
(636) 257-6503

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2000146274
MO

Other

Enumeration date
06/19/2007
Last updated
07/08/2007
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