SHANE LOWELL KOPPENHAVER

FORT SAM HOUSTON, TX
NPI1952385163
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2251X0800X Physical Therapist, Orthopedic
(Licence: VA  2305006682)
Enumeration Date2005-12-01
Last Update Date2007-07-08
Business Address
Mr. SHANE LOWELL KOPPENHAVER MPT, OCS
3851 ROGER BROOKE DR (BAMC MCHE-QD/ CREDENTIALS)
FORT SAM HOUSTON, TX 78234-4501
Phone number: 210-916-1920
Mailing Address
Mr. SHANE LOWELL KOPPENHAVER MPT, OCS
424 NORMANDY AVE
SAN ANTONIO, TX 78209-4543
Phone number:
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