Individual
JORDAN KNOPPERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
1 WAHOO AVE, GROTON, CT 06349-2324
(860) 694-2073
Mailing address
1390 SANTA ALICIA AVE APT 9204, CHULA VISTA, CA 91913-1857
(631) 609-0679
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CT
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/07/2020
Last updated
02/17/2026
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