MEDICARE: BRYAN KAPPE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	34977	CA

General Provider Information

NPI Number	:	1376147504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRYAN KAPPE

Provider Business Mailing Address
First Line	:	401 WASHINGTON ST
Second Line	:
City	:	PETALUMA
State	:	CA
Zip	:	94952-2998
Country	:	US
Telephone Number	:	707-778-7010
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 WASHINGTON ST
Second Line	:
City	:	PETALUMA
State	:	CA
Zip	:	94952-2998
Country	:	US
Telephone Number	:	707-778-7010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2020
Last Update Date	:	04/19/2024

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Directions to “ BRYAN KAPPE ” Practice Location

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