Provider Demographics
NPI:1336734367
Name:BRANDON L SIPPLE
Entity Type:Organization
Organization Name:BRANDON L SIPPLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:L
Authorized Official - Last Name:SIPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-302-5353
Mailing Address - Street 1:502 RICHMOND RD N STE 2
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-1151
Mailing Address - Country:US
Mailing Address - Phone:859-986-2225
Mailing Address - Fax:
Practice Address - Street 1:502 RICHMOND RD N STE 2
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1151
Practice Address - Country:US
Practice Address - Phone:859-986-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty