MEDICARE: DR. NICOLE LYNNE PHIPPS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301007185	MI

General Provider Information

NPI Number	:	1912124165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLE LYNNE PHIPPS D.C.

Provider Business Mailing Address
First Line	:	1288 CLEAR CREEK DR
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48306-3577
Country	:	US
Telephone Number	:	248-652-2992
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 ROCHDALE DR S STE B
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-2274
Country	:	US
Telephone Number	:	248-652-8686
Fax Number	:	248-601-2933

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	05/13/2014

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