Organization
GREAT RIVER MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA A KOPP DO (GENERAL PTR)
(563) 441-9100
Entity
Organization
Contact information
Practice address
4626 PROGRESS DR, DAVENPORT, IA 52807-3483
(563) 441-9100
(563) 441-9101
Mailing address
4626 PROGRESS DR, DAVENPORT, IA 52807-3483
(563) 441-9100
(563) 441-9101
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
03155
IA
Other
Enumeration date
01/12/2006
Last updated
08/22/2020
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