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1063634699
BETHANY DAWN COPPOCK
MARION, IN
NPI
1063634699
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IN 32001358A)
Enumeration Date
2007-05-03
Last Update Date
2007-07-08
Business Address
-- BETHANY DAWN COPPOCK COTA
4725 COLONIAL OAKS DRIVE
MARION, IN 46953
Phone number: 765-674-9791
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Mailing Address
-- BETHANY DAWN COPPOCK COTA
802 S BARCLAY ST
FAIRMOUNT, IN 46928
Phone number: 765-251-1531
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