Provider Demographics
NPI:1003235854
Name:LOBBESTAEL, THERESA (DC)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:
Last Name:LOBBESTAEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:985 MARKET ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-6533
Mailing Address - Country:US
Mailing Address - Phone:803-547-9800
Mailing Address - Fax:803-547-9804
Practice Address - Street 1:985 MARKET ST STE 201
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-6533
Practice Address - Country:US
Practice Address - Phone:803-547-9800
Practice Address - Fax:803-547-9804
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDC3905111N00000X
SC3905111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor