JACOB R POPPINGA

BAXTER, MN
NPI1417556762
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN  305402)
Enumeration Date2020-10-19
Last Update Date2020-10-19
Business Address
JACOB R POPPINGA LADC
13045 FALCON DR STE 7404TH
BAXTER, MN 56425-4201
Phone number: 218-821-4538
Mailing Address
JACOB R POPPINGA LADC
1415 S 6TH ST
BRAINERD, MN 56401-4347
Phone number: 218-821-4538
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