Provider Demographics
NPI:1235637430
Name:COPLAND, KYLIE SHEILA MILLS
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:SHEILA MILLS
Last Name:COPLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 ELM ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2244
Mailing Address - Country:US
Mailing Address - Phone:978-505-3618
Mailing Address - Fax:
Practice Address - Street 1:502 ELM ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2244
Practice Address - Country:US
Practice Address - Phone:978-505-3618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer