Provider Demographics
NPI:1932272556
Name:KRIMPELBEIN, KENNETH DOUGLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:DOUGLAS
Last Name:KRIMPELBEIN
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:S76 W25985 W. PRAIRIESIDE DR.
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53189-6902
Mailing Address - Country:US
Mailing Address - Phone:262-662-2133
Mailing Address - Fax:
Practice Address - Street 1:1900 W RYAN RD
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-8233
Practice Address - Country:US
Practice Address - Phone:414-761-5777
Practice Address - Fax:414-761-7915
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3183-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38885000Medicaid
WI38885000Medicaid