Provider Demographics
NPI:1124217518
Name:AIPPERSPACH, KENNETH DALE
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:DALE
Last Name:AIPPERSPACH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4745 ARAPAHOE AVE STE 100
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1082
Mailing Address - Country:US
Mailing Address - Phone:303-444-3000
Mailing Address - Fax:303-444-3226
Practice Address - Street 1:4745 ARAPAHOE AVE STE 100
Practice Address - Street 2:SUITE 100
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1082
Practice Address - Country:US
Practice Address - Phone:303-444-3000
Practice Address - Fax:303-444-3226
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO027974156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician