Provider Demographics
NPI:1972897148
Name:JOUPPI, AMY (PT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:JOUPPI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 HIGHWAY 2
Mailing Address - Street 2:
Mailing Address - City:TWO HARBORS
Mailing Address - State:MN
Mailing Address - Zip Code:55616-4049
Mailing Address - Country:US
Mailing Address - Phone:218-834-2586
Mailing Address - Fax:218-834-2587
Practice Address - Street 1:1451 HIGHWAY 2
Practice Address - Street 2:
Practice Address - City:TWO HARBORS
Practice Address - State:MN
Practice Address - Zip Code:55616-4049
Practice Address - Country:US
Practice Address - Phone:218-834-2586
Practice Address - Fax:218-834-2587
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7215225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist