Provider Demographics
NPI:1871847038
Name:HOEPPNER, JAKE DONALD (DPT)
Entity Type:Individual
Prefix:DR
First Name:JAKE
Middle Name:DONALD
Last Name:HOEPPNER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 19TH ST NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-6606
Mailing Address - Country:US
Mailing Address - Phone:507-322-3460
Mailing Address - Fax:
Practice Address - Street 1:3100 19TH ST NW
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-6606
Practice Address - Country:US
Practice Address - Phone:507-322-3460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN90292251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic