Provider Demographics
NPI:1902893449
Name:KAPPER, SHAWN CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:CHRISTOPHER
Last Name:KAPPER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 N CROSS ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-1043
Mailing Address - Country:US
Mailing Address - Phone:330-365-2434
Mailing Address - Fax:330-343-9761
Practice Address - Street 1:1716 N CROSS ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-1043
Practice Address - Country:US
Practice Address - Phone:330-365-2434
Practice Address - Fax:330-343-9761
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2693111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4012501Medicare ID - Type Unspecified
OHU79161Medicare UPIN