Individual
DR. JERRY O SIPPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3090 ANGEL DR, BETHEL, OH 45106-9533
(513) 734-6555
Mailing address
3090 ANGEL DR, BETHEL, OH 45106-9533
(513) 734-6555
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3801
KY
111N00000X
Chiropractor
Primary
DC-1340
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000013728
BLUE CROSS BLUE SHIELD ID
OH
05
—
0689278
—
OH
01
—
1340C-31-1224185
HUMANA
OH
01
—
44-80841
UNITED HEALTHCARE
OH
Enumeration date
10/23/2006
Last updated
04/19/2012
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