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Individual

JEFFREY DAVID KUPPERSMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
610 N GILBERT RD, SUITE 309, GILBERT, AZ 85234-4502
(480) 926-1111
(480) 926-2958
Mailing address
610 N GILBERT RD, SUITE 309, GILBERT, AZ 85234-4502
(480) 926-1111
(480) 926-2958

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7280
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
619494
AZ
Enumeration date
01/16/2006
Last updated
12/21/2011
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