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NPI Code Detail

MEDICARE: HANNAH HOPPA MAT, LAT, ATC

MEDICARE:   HANNAH  HOPPA  MAT, LAT, ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer3004-39WI

General Provider Information

NPI Number : 1306725205
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH HOPPA MAT, LAT, ATC
Provider Business Mailing Address
First Line : 3111 GUNDERSEN DR
Second Line :
City : ONALASKA
State : WI
Zip : 54650-8405
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3111 GUNDERSEN DR
Second Line :
City : ONALASKA
State : WI
Zip : 54650-8405
Country : US
Telephone Number : 608-775-8760
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2025
Last Update Date : 08/27/2025

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Directions to “ HANNAH HOPPA MAT, LAT, ATC” Practice Location

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