Provider Demographics
NPI:1881282572
Name:KOPECHEK, REBECCA (LAT, ATC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:KOPECHEK
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:SPIEGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1331 HIDEAWAY WOODS DR APT D
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-5123
Mailing Address - Country:US
Mailing Address - Phone:614-600-8887
Mailing Address - Fax:
Practice Address - Street 1:1331 HIDEAWAY WOODS DR APT D
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-5123
Practice Address - Country:US
Practice Address - Phone:614-600-8887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0058522081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine