Provider Demographics
NPI:1255407540
Name:RIPPEE, BRUCE M (DC)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:M
Last Name:RIPPEE
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 1:305 NW ENGLEWOOD COURT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64118
Mailing Address - Country:US
Mailing Address - Phone:816-454-5433
Mailing Address - Fax:816-454-8455
Practice Address - Street 1:305 NW ENGLEWOOD COURT
Practice Address - Street 2:SUITE 200
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118
Practice Address - Country:US
Practice Address - Phone:816-454-5433
Practice Address - Fax:816-454-8455
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005977111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U29742Medicare UPIN
D510893Medicare ID - Type Unspecified