Provider Demographics
NPI:1881914133
Name:RUPPERT, CAROLINE JEAN (DC)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:JEAN
Last Name:RUPPERT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 COTTAGE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53527-8862
Mailing Address - Country:US
Mailing Address - Phone:608-839-3513
Mailing Address - Fax:608-839-3533
Practice Address - Street 1:2850 COTTAGE GROVE RD
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:WI
Practice Address - Zip Code:53527-8862
Practice Address - Country:US
Practice Address - Phone:608-839-3513
Practice Address - Fax:608-839-3533
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4615-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor