Provider Demographics
NPI:1992468359
Name:KLIPFEL, MACAYLA D
Entity Type:Individual
Prefix:
First Name:MACAYLA
Middle Name:D
Last Name:KLIPFEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 S SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-4220
Mailing Address - Country:US
Mailing Address - Phone:719-252-5758
Mailing Address - Fax:
Practice Address - Street 1:245 S SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-4220
Practice Address - Country:US
Practice Address - Phone:719-252-5758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist