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Individual
DR. JERRY WILLIAM DIPPE
Active
Individual
DR. JERRY WILLIAM DIPPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
DC001454L
PA
111N00000X
Chiropractor
Primary
DC10776
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ542232
BLUE SHIELD
CA
Enumeration date
02/27/2007
Last updated
06/09/2008
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