Provider Demographics
NPI:1871038851
Name:HOPP, MARCUS (ATC)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:
Last Name:HOPP
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073-1052
Mailing Address - Country:US
Mailing Address - Phone:507-217-5650
Mailing Address - Fax:507-217-5247
Practice Address - Street 1:1808 WILLOW RD
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-1052
Practice Address - Country:US
Practice Address - Phone:507-217-5650
Practice Address - Fax:507-217-5247
Is Sole Proprietor?:No
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN15042255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer