Individual
JENNA L KOEPPEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1032 E SUMNER ST, HARTFORD, WI 53027-1608
(262) 670-4300
(262) 670-4303
Mailing address
N163W20080 ASH DR, JACKSON, WI 53037-9251
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10488
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36103700
—
WI
Enumeration date
05/21/2007
Last updated
07/08/2007
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