Provider Demographics
NPI:1477824134
Name:SIEPLER, DANIEL CJ (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:CJ
Last Name:SIEPLER
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 1:2033 ALTA AVE
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-1101
Mailing Address - Country:US
Mailing Address - Phone:812-797-5615
Mailing Address - Fax:
Practice Address - Street 1:2212 DUNDEE RD
Practice Address - Street 2:SUITE C
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-1888
Practice Address - Country:US
Practice Address - Phone:502-594-8326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002629A111N00000X
KY5357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor