Provider Demographics
NPI:1053683763
Name:LOPSHIRE, JENNIFER L (DC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:LOPSHIRE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 S EMERSON
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-0000
Mailing Address - Country:US
Mailing Address - Phone:317-522-2303
Mailing Address - Fax:317-522-2304
Practice Address - Street 1:4625 S EMERSON
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-0000
Practice Address - Country:US
Practice Address - Phone:317-522-2303
Practice Address - Fax:317-522-2304
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002623A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor