Provider Demographics
NPI:1225377344
Name:KOPICKI, KYLE (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:
Last Name:KOPICKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3254 W RIDGE PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LIMERICK
Mailing Address - State:PA
Mailing Address - Zip Code:19464
Mailing Address - Country:US
Mailing Address - Phone:484-455-4664
Mailing Address - Fax:484-455-4498
Practice Address - Street 1:3254 W RIDGE PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19464
Practice Address - Country:US
Practice Address - Phone:484-455-4664
Practice Address - Fax:484-455-4498
Is Sole Proprietor?:No
Enumeration Date:2013-02-08
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010708111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor