Healthcare Provider Details

I. General information

NPI: 1609830421
Provider Name (Legal Business Name): DEBBY ANN LIPKA D.C
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35517 23 MILE RD
NEW BALTIMORE MI
48047-3603
US

IV. Provider business mailing address

35517 23 MILE RD
NEW BALTIMORE MI
48047-3603
US

V. Phone/Fax

Practice location:
  • Phone: 586-725-8700
  • Fax: 586-725-6251
Mailing address:
  • Phone: 586-725-8700
  • Fax: 586-725-6251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301006697
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: