Provider Demographics
NPI:1174665533
Name:KEPLER, SHANE D (DC)
Entity Type:Individual
Prefix:DR
First Name:SHANE
Middle Name:D
Last Name:KEPLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4727 N 26TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-4706
Mailing Address - Country:US
Mailing Address - Phone:402-438-2090
Mailing Address - Fax:402-438-4750
Practice Address - Street 1:4727 N 26TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-4706
Practice Address - Country:US
Practice Address - Phone:402-438-2090
Practice Address - Fax:402-438-4750
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE273001Medicare ID - Type UnspecifiedPROVIDER NUMBER