Individual
OPAL ANN KOEPPEL WILLCOXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 W TAYLOR AVE APT 233, MOSCOW, ID 83843-4417
(208) 310-2435
Mailing address
201 W TAYLOR AVE APT 233, MOSCOW, ID 83843-4417
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/31/2022
Last updated
06/01/2022
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