Provider Demographics
NPI:1275557001
Name:SCHLEPER, KEITH R (BA DC)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:R
Last Name:SCHLEPER
Suffix:
Gender:M
Credentials:BA DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 FRONTAGE RD N STE 19
Mailing Address - Street 2:
Mailing Address - City:WAITE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:56387-1869
Mailing Address - Country:US
Mailing Address - Phone:320-493-3529
Mailing Address - Fax:320-229-2647
Practice Address - Street 1:2103 FRONTAGE RD N STE 19
Practice Address - Street 2:
Practice Address - City:WAITE PARK
Practice Address - State:MN
Practice Address - Zip Code:56387-1869
Practice Address - Country:US
Practice Address - Phone:320-252-2703
Practice Address - Fax:320-229-2647
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4622111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN317P4SCOtherBLUE CROSS/BLUE SHIELD
MN084908100OtherDEPT. OF HUMAN SERVICES
MN317P4SCOtherBLUE CROSS/BLUE SHIELD