Provider Demographics
NPI:1619488947
Name:FAIPLER, KAITLYN BASSETT (DC)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:BASSETT
Last Name:FAIPLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:LAFAVE
Other - Last Name:BASSETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8734 MONTEREY BAY LOOP
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-6318
Mailing Address - Country:US
Mailing Address - Phone:517-581-7898
Mailing Address - Fax:
Practice Address - Street 1:6220 MANATEE AVE W STE 204
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-2361
Practice Address - Country:US
Practice Address - Phone:941-761-1100
Practice Address - Fax:941-761-1103
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12322111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor