Provider Demographics
NPI:1013996024
Name:SAMPEDRO, FRANKLIN ANDRES (DC)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:ANDRES
Last Name:SAMPEDRO
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 1:5260 KALAMAZOO AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-6131
Mailing Address - Country:US
Mailing Address - Phone:616-308-2269
Mailing Address - Fax:
Practice Address - Street 1:5260 KALAMAZOO AVE SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-6131
Practice Address - Country:US
Practice Address - Phone:616-827-2350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION43580Medicare ID - Type UnspecifiedMEDICARE ID #