Healthcare Provider Details

I. General information

NPI: 1144461005
Provider Name (Legal Business Name): KREPS CHIPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 12/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 CENTER AVE W SUITE B
DILWORTH MN
56529-1346
US

IV. Provider business mailing address

1675 CENTER AVE W SUITE B
DILWORTH MN
56529-1346
US

V. Phone/Fax

Practice location:
  • Phone: 218-236-1187
  • Fax: 218-236-8514
Mailing address:
  • Phone: 218-236-1187
  • Fax: 218-236-8514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number2116
License Number StateMN

VIII. Authorized Official

Name: DR. DAVID JAMES KREPS
Title or Position: OWNER
Credential: D. C.
Phone: 218-236-1187