Provider Demographics
NPI:1427327469
Name:KOPILOW, NATALIYA K (MT)
Entity type:Individual
Prefix:MRS
First Name:NATALIYA
Middle Name:K
Last Name:KOPILOW
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 SONOMA STR
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558
Mailing Address - Country:US
Mailing Address - Phone:707-287-8209
Mailing Address - Fax:
Practice Address - Street 1:2989 SOLANO AVE
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-4610
Practice Address - Country:US
Practice Address - Phone:707-287-8209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29989111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner