Individual
TERRY W KOPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11725 STINSON AVE, CHISAGO CITY, MN 55013-9542
(651) 257-8499
Mailing address
5200 FAIRVIEW BLVD, WYOMING, MN 55092-8013
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31109
MN
Other
Enumeration date
05/12/2006
Last updated
06/16/2008
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