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General NPI Number Information
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NPI Number | 1447773379
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Entity Type | Individual
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Provider Name | ADAM KIEPERT DPT
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Gender | Male
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Dates
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Enumeration Date | 07/23/2017
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 4501 BROADWAY
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City | OAKLAND
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State | CA
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Zip | 94611-4615
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Country | US
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Telephone | 510-752-6390
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Fax |
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Provider Business Mailing Address
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Address Line | W5846 ARBOR RD
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City | FORT ATKINSON
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State | WI
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Zip | 53538-8909
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Country | US
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Telephone | 920-723-7799
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 13840-24
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License Number State | WI
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