Provider Demographics
NPI:1588724926
Name:KIEFFER, JEFFREY F (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:F
Last Name:KIEFFER
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 1:667 OLD HIGHWAY 30
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:ID
Mailing Address - Zip Code:83647-6202
Mailing Address - Country:US
Mailing Address - Phone:208-587-4804
Mailing Address - Fax:208-587-4889
Practice Address - Street 1:667 OLD HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:ID
Practice Address - Zip Code:83647-6202
Practice Address - Country:US
Practice Address - Phone:208-587-4804
Practice Address - Fax:208-587-4889
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA567111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T81823Medicare UPIN
ID1672303Medicare ID - Type Unspecified