Provider Demographics
NPI:1255805917
Name:KLOEPPER, JORDAN RACHELLE (DC)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:RACHELLE
Last Name:KLOEPPER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:RACHELLE
Other - Last Name:VAN NESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:402 DELAWARE STREET
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048
Mailing Address - Country:US
Mailing Address - Phone:816-244-9783
Mailing Address - Fax:
Practice Address - Street 1:402 DELAWARE STREET
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048
Practice Address - Country:US
Practice Address - Phone:816-244-9783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-16
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05959111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor