Individual
DENISE SUSAN COPPOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D-PT
Contact information
Practice address
820 ARBUTUS AVE, OCONTO, WI 54153-2004
(920) 835-1100
(920) 835-1099
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15769-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100200277
—
WI
Enumeration date
05/04/2022
Last updated
07/17/2024
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