Provider Demographics
NPI:1346390556
Name:SCHIPPER, KYLE ANTONY (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:ANTONY
Last Name:SCHIPPER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 3RD STREET NE
Mailing Address - Street 2:
Mailing Address - City:FARLEY
Mailing Address - State:IA
Mailing Address - Zip Code:52046
Mailing Address - Country:US
Mailing Address - Phone:515-341-0916
Mailing Address - Fax:
Practice Address - Street 1:407 3RD STREET NE
Practice Address - Street 2:
Practice Address - City:FARLEY
Practice Address - State:IA
Practice Address - Zip Code:52046
Practice Address - Country:US
Practice Address - Phone:515-341-0916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06941111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor