Individual
MR. DANIEL MADISON LENT KOOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT, CHT
Contact information
Practice address
3001 BROADMOOR BLVD NE, RIO RANCHO, NM 87144-2100
(505) 994-7131
(505) 994-7155
Mailing address
5817 RIO ANIMAS RD NE, RIO RANCHO, NM 87144-4719
(505) 206-4625
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4129
NM
2251H1200X
Hand Physical Therapist
1061100674
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4129
PT LICENSE
NM
01
—
650001175
MEDICARE
—
Enumeration date
07/28/2006
Last updated
01/28/2013
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