Provider Demographics
NPI:1265889968
Name:KOPCZYNSKI, MOLLY (DPT)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:KOPCZYNSKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7821 W 38TH AVE
Mailing Address - Street 2:#101
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6109
Mailing Address - Country:US
Mailing Address - Phone:303-333-3493
Mailing Address - Fax:303-420-4649
Practice Address - Street 1:7821 W 38TH AVE
Practice Address - Street 2:#101
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6109
Practice Address - Country:US
Practice Address - Phone:303-333-3493
Practice Address - Fax:303-420-4649
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0013984225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist