Healthcare Provider Details

I. General information

NPI: 1821954637
Provider Name (Legal Business Name): KIMBERLY WERT RIPLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/25/2025
Last Update Date: 12/25/2025
Certification Date: 12/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1297 BRYAN RD
O FALLON MO
63366-3729
US

IV. Provider business mailing address

1482 PARKSIDE COMMONS CT APT 302
VALLEY PARK MO
63088-1528
US

V. Phone/Fax

Practice location:
  • Phone: 636-294-0070
  • Fax:
Mailing address:
  • Phone: 636-294-0070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2025053699
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: