Provider Demographics
NPI:1043391931
Name:SIPPLE, EILEEN M (DC)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:M
Last Name:SIPPLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3090 ANGEL DR
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:OH
Mailing Address - Zip Code:45106-9533
Mailing Address - Country:US
Mailing Address - Phone:513-734-6555
Mailing Address - Fax:
Practice Address - Street 1:3090 ANGEL DR
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:OH
Practice Address - Zip Code:45106-9533
Practice Address - Country:US
Practice Address - Phone:513-734-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH-1646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2489661001OtherMEDICAL MUTUAL ID
OH000000013728OtherBLUE CROSS BLUE SHIELD ID
OH0689278Medicaid
OH1340C-31-1224185OtherHUMANA
OH44-80841OtherUNITED HEALTHCARE
OH44-80841OtherUNITED HEALTHCARE