Provider Demographics
NPI:1265790992
Name:SEPPALA, ANDREW BRYAN (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:BRYAN
Last Name:SEPPALA
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 1:1297 KILBERY LN
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-4604
Mailing Address - Country:US
Mailing Address - Phone:952-239-6235
Mailing Address - Fax:
Practice Address - Street 1:1297 KILBERY LN
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-4604
Practice Address - Country:US
Practice Address - Phone:952-239-6235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5665111N00000X
IL038012287111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0200XChiropractic ProvidersChiropractorRadiology