Provider Demographics
NPI:1831762905
Name:KNIPPER, JORDYNNE LEI (DPT)
Entity type:Individual
Prefix:
First Name:JORDYNNE
Middle Name:LEI
Last Name:KNIPPER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 11TH ST SE STE A
Mailing Address - Street 2:
Mailing Address - City:DYERSVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52040-2418
Mailing Address - Country:US
Mailing Address - Phone:563-875-8615
Mailing Address - Fax:
Practice Address - Street 1:1129 11TH ST SE STE A
Practice Address - Street 2:
Practice Address - City:DYERSVILLE
Practice Address - State:IA
Practice Address - Zip Code:52040-2418
Practice Address - Country:US
Practice Address - Phone:563-875-8615
Practice Address - Fax:563-875-8722
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA107281225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA107281OtherIOWA DEPARTMENT OF PUBLIC HEALTH BOARD OF PHYSICAL AND OCCUPATIONAL THERAPY