Provider Demographics
NPI:1730402405
Name:WHIPPLE, LAURA A (DC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:WHIPPLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 W GATE BLVD
Mailing Address - Street 2:SUITE A102
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1479
Mailing Address - Country:US
Mailing Address - Phone:512-448-0900
Mailing Address - Fax:512-358-0800
Practice Address - Street 1:4701 W GATE BLVD
Practice Address - Street 2:SUITE A102
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1479
Practice Address - Country:US
Practice Address - Phone:512-448-0900
Practice Address - Fax:512-358-0800
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX08932111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor