Frank T Coppolino Jr., CP

Individual provider Active NPI Prosthetist · Imperial, MO

NPI 1972803773 · NPPES record last updated Oct 26, 2010

Key facts

NPI
1972803773
Entity type
Individual (NPI type 1)
Primary specialty
Prosthetist 224P00000X
Practice address
5425 Regency Woods MNR
Imperial, MO 63052-1971
Phone
(812) 589-2069
NPI assigned
Oct 26, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetist 224P00000X Yes

Addresses

Primary practice location

5425 Regency Woods MNR
Imperial, MO 63052-1971

Mailing address

5425 Regency Woods MNR
Imperial, MO 63052-1971
Phone (812) 589-2069

Other providers in Imperial, MO

All providers in Imperial, MO · Prosthetist in Missouri

Sources for this page

Verify at the official NPI Registry.