Most Relevant Information
Provider Data
| NPI Number: | 1003534538 |
| Provider Name: | DEREK M KOPANIC |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT020106 |
Most Important Dates
| Enumeration Date: | 08/19/2022 |
| Last Updated: | 08/19/2022 |
Provider Practice Location
7171 KECK PARK CIR NW
NORTH CANTON
OH
447206301
Practice Location Phone/Fax
| Phone: | 3304985222 |
| Fax: |
Provider Mailing Location
7171 KECK PARK CIR NW
NORTH CANTON
OH
447206301
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |