Provider Demographics
NPI:1407972540
Name:DUPPENTHALER, JOHN E (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:DUPPENTHALER
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 1:6659 KIMBALL DR
Mailing Address - Street 2:SUITE A-102
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-5137
Mailing Address - Country:US
Mailing Address - Phone:253-857-9100
Mailing Address - Fax:253-857-3110
Practice Address - Street 1:6659 KIMBALL DR
Practice Address - Street 2:SUITE A-102
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-5137
Practice Address - Country:US
Practice Address - Phone:253-857-9100
Practice Address - Fax:253-857-3110
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor