Theresa Koppal, PA-C

NPI #1033510508 in Gilbert, Arizona

Provider Information

NPI Number: 1033510508
Entity Type: Individual
Name: Theresa Koppal, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Sep 15, 2014
Last Updated: Jul 29, 2022

Practice Location

Address: 2940 E BANNER GATEWAY DR STE 200-250
City: Gilbert
State: Arizona
ZIP Code: 85234-2168
Phone: (602) 548-5444

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant - Surgical — Surgical	363AS0400X
Physician Assistant	363A00000X	Primary

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