Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 2817 | CO |
N | 111NS0005X | Chiropractic Sports Physician | 2817 | CO |
NPI | 1124139258 |
---|---|
Provider Name | Dr. Kathy Jane Koop |
First Address | Denver, CO 80224-2559 |
Second Address | Denver, CO 80224-2559 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U21799 | (02) | CO |