Provider Demographics
NPI:1437321767
Name:KOPP, CHRISTOPHER K (PT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:K
Last Name:KOPP
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 BEACHWOOD CT
Mailing Address - Street 2:SUITE 203
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-5706
Mailing Address - Country:US
Mailing Address - Phone:904-996-6922
Mailing Address - Fax:904-996-6923
Practice Address - Street 1:3500 BEACHWOOD CT
Practice Address - Street 2:SUITE 203
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-5706
Practice Address - Country:US
Practice Address - Phone:904-996-6922
Practice Address - Fax:904-996-6923
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT0013725225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist