Provider Demographics
NPI:1568576973
Name:KOPRIVA, ANGELA EMMA (ATC)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:EMMA
Last Name:KOPRIVA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41577 169TH ST
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:SD
Mailing Address - Zip Code:57258-6624
Mailing Address - Country:US
Mailing Address - Phone:605-468-0001
Mailing Address - Fax:
Practice Address - Street 1:1000 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82071-2000
Practice Address - Country:US
Practice Address - Phone:307-766-2712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer