Provider Demographics
NPI:1962921940
Name:COPPOCK, ALLISON (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:COPPOCK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3214 RIVER PARK LN S APT 1413
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-1126
Mailing Address - Country:US
Mailing Address - Phone:972-351-1348
Mailing Address - Fax:
Practice Address - Street 1:800 ORTHOPEDIC WAY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-1629
Practice Address - Country:US
Practice Address - Phone:817-375-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist