Provider Demographics
NPI:1033140751
Name:KOPPER, LINDA NOLA (PT)
Entity Type:Individual
Prefix:MISS
First Name:LINDA
Middle Name:NOLA
Last Name:KOPPER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 LAMOILLE VIEW LN
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05464-4427
Mailing Address - Country:US
Mailing Address - Phone:802-644-8011
Mailing Address - Fax:802-644-8047
Practice Address - Street 1:44 LAMOILLE VIEW LN
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:VT
Practice Address - Zip Code:05464-4427
Practice Address - Country:US
Practice Address - Phone:802-644-8011
Practice Address - Fax:802-644-8047
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist