Provider Demographics
NPI:1831675727
Name:COPE, KAREN (PTA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:COPE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 ARNALL LN
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-8804
Mailing Address - Country:US
Mailing Address - Phone:918-721-3313
Mailing Address - Fax:
Practice Address - Street 1:305 ARNALL LN
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-8804
Practice Address - Country:US
Practice Address - Phone:918-721-3313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1205225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
$$$$$$$$$OtherPRIVATE