Individual
MR. PETER G COPPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P. T.
Contact information
Practice address
6504 NE SISKIYOU ST, PORTLAND, OR 97213-4572
(503) 893-8987
Mailing address
3024 NE 67TH AVE, PORTLAND, OR 97213-5204
(503) 893-8987
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60861
OR
Other
Enumeration date
04/14/2006
Last updated
12/29/2018
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