Provider Demographics
NPI:1558817866
Name:KOPROWICZ, COURTNEY (CMT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:KOPROWICZ
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 243
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93464-0243
Mailing Address - Country:US
Mailing Address - Phone:805-232-8168
Mailing Address - Fax:
Practice Address - Street 1:546 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BUELLTON
Practice Address - State:CA
Practice Address - Zip Code:93427-9750
Practice Address - Country:US
Practice Address - Phone:805-232-8168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-27
Last Update Date:2016-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist