Individual
DR. MICHAEL JOSEPH COPPERSMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
433 W WATER ST, PRINCETON, WI 54968-9148
(920) 295-6741
(920) 295-6741
Mailing address
433 W WATER ST, PO BOX 447, PRINCETON, WI 54968-9148
(920) 295-6741
(920) 295-6741
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3930-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000023001
MEDICARE PROVIDER #
WI
05
—
38950900
—
WI
Enumeration date
11/08/2006
Last updated
04/07/2009
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