Mitchell Sopko, OT

Individual provider Active NPI Occupational Therapist · Bullhead City, AZ

NPI 1396243184 · NPPES record last updated Jan 25, 2018

Key facts

NPI
1396243184
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
Practice address
2812 Silver Creek Rd
Bullhead City, AZ 86442-8309
Phone
(928) 763-1404
NPI assigned
Jan 25, 2018
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Yes

Addresses

Primary practice location

2812 Silver Creek Rd
Bullhead City, AZ 86442-8309

Mailing address

2812 Silver Creek Rd
Bullhead City, AZ 86442-8309

Other providers in Bullhead City, AZ

All providers in Bullhead City, AZ · Occupational Therapist in Arizona

Sources for this page

Verify at the official NPI Registry.