Provider Demographics
NPI:1134254261
Name:KEPPLER, DAVID ERIC (PT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ERIC
Last Name:KEPPLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3590 MARY ADER AVE
Mailing Address - Street 2:APT. 1231
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5784
Mailing Address - Country:US
Mailing Address - Phone:843-697-2599
Mailing Address - Fax:843-852-2296
Practice Address - Street 1:3590 MARY ADER AVE
Practice Address - Street 2:APT. 1231
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5784
Practice Address - Country:US
Practice Address - Phone:843-697-2599
Practice Address - Fax:843-852-2296
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5348225100000X
NJQA005869225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ051441P7MMedicare ID - Type UnspecifiedPHYSICAL THERAPY