Healthcare Provider Details

I. General information

NPI: 1811470420
Provider Name (Legal Business Name): KUPPER AND KEENER CHIROPRACTIC, APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2018
Last Update Date: 09/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 N EL CAMINO REAL STE 110
ENCINITAS CA
92024-2812
US

IV. Provider business mailing address

317 N EL CAMINO REAL STE 110
ENCINITAS CA
92024-2812
US

V. Phone/Fax

Practice location:
  • Phone: 760-456-9470
  • Fax:
Mailing address:
  • Phone: 760-456-9470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN BARRETT KUPPER
Title or Position: PRESIDENT
Credential: DC
Phone: 760-456-9470