Provider Demographics
NPI:1629616933
Name:COPELLE, JANET K (LMT)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:K
Last Name:COPELLE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 S BROADWAY UNIT E
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507
Mailing Address - Country:US
Mailing Address - Phone:970-644-5255
Mailing Address - Fax:
Practice Address - Street 1:2500 S BROADWAY
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81507
Practice Address - Country:US
Practice Address - Phone:970-644-5255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT0022822225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist