Provider Demographics
NPI:1952310690
Name:COPE, KEVIN M (PT)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:M
Last Name:COPE
Suffix:
Gender:M
Credentials:PT
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Other - Credentials:
Mailing Address - Street 1:20347 TIMBERLAKE RD
Mailing Address - Street 2:STE B
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7352
Mailing Address - Country:US
Mailing Address - Phone:434-845-9054
Mailing Address - Fax:434-528-2788
Practice Address - Street 1:118 OAKWOOD DR
Practice Address - Street 2:STE B
Practice Address - City:MADISON HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:24572-3001
Practice Address - Country:US
Practice Address - Phone:434-845-9053
Practice Address - Fax:434-528-2788
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2016-11-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA2305001659225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA650013624Medicare ID - Type UnspecifiedMEDICARE RAILROAD
VA650000180Medicare ID - Type Unspecified