Provider Demographics
NPI:1609110337
Name:BOPP, JOYLYN TAMARA (ND)
Entity Type:Individual
Prefix:DR
First Name:JOYLYN
Middle Name:TAMARA
Last Name:BOPP
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2039 PINE ST APT A
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-4565
Mailing Address - Country:US
Mailing Address - Phone:720-509-9659
Mailing Address - Fax:
Practice Address - Street 1:2299 PEARL ST
Practice Address - Street 2:SUITE 205
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-4668
Practice Address - Country:US
Practice Address - Phone:720-509-9659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT 60264667175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath