Provider Demographics
NPI:1982107637
Name:KILPS, MARIAH LOUISE (DC)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:LOUISE
Last Name:KILPS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MARIAH
Other - Middle Name:LOUISE
Other - Last Name:MIELKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2909 S QUILLAN ST
Mailing Address - Street 2:STE 158
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-2437
Mailing Address - Country:US
Mailing Address - Phone:509-579-5992
Mailing Address - Fax:509-579-5993
Practice Address - Street 1:2909 S QUILLAN ST STE 158
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99337-2437
Practice Address - Country:US
Practice Address - Phone:541-604-2829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60817975111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor