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General NPI Number Information
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NPI Number | 1578200911
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Entity Type | Individual
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Provider Name | EMILY TRIPP DC
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Gender | Female
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Dates
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Enumeration Date | 05/17/2022
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Last Update Date | 05/17/2022
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Provider Practice Location Address
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Address Line | 2770 COOLIDGE HWY
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City | BERKLEY
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State | MI
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Zip | 48072-1557
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Country | US
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Telephone | 248-397-8122
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Fax |
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Provider Business Mailing Address
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Address Line | 4826 226TH PL NE
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City | ARLINGTON
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State | WA
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Zip | 98223-7286
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Country | US
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Telephone | 425-783-9718
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301401258
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License Number State | MI
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