Provider Demographics
NPI:1457321689
Name:KRAMER, JEFFREY R (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:R
Last Name:KRAMER
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:PO BOX 269
Mailing Address - Street 2:
Mailing Address - City:TRIPP
Mailing Address - State:SD
Mailing Address - Zip Code:57376-0269
Mailing Address - Country:US
Mailing Address - Phone:605-935-6116
Mailing Address - Fax:605-935-6118
Practice Address - Street 1:301 S MAIN ST
Practice Address - Street 2:
Practice Address - City:TRIPP
Practice Address - State:SD
Practice Address - Zip Code:57376-0269
Practice Address - Country:US
Practice Address - Phone:605-935-6116
Practice Address - Fax:605-935-6118
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD888111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS41846Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
SDU69586Medicare UPIN
SDS41850Medicare ID - Type Unspecified