Individual
MARY KOPACKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC, PTA
Contact information
Practice address
7 CRAPE MYRTLE CIR, BROWNS SUMMIT, NC 27214-9460
(561) 596-2870
Mailing address
7 CRAPE MYRTLE CIR, BROWNS SUMMIT, NC 27214-9460
(561) 596-2870
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
AL1739
FL
171W00000X
Contractor
Primary
LAT1595
NC
Other
Enumeration date
06/21/2016
Last updated
06/21/2016
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