Provider Demographics
NPI:1144116930
Name:ALDRIDGE RHINE, TIFFANY LYNNE (OD)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:LYNNE
Last Name:ALDRIDGE RHINE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:LYNNE
Other - Last Name:RHINE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:517 TERRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021-4467
Mailing Address - Country:US
Mailing Address - Phone:660-253-1242
Mailing Address - Fax:
Practice Address - Street 1:1000 DES PERES RD
Practice Address - Street 2:
Practice Address - City:DES PERES
Practice Address - State:MO
Practice Address - Zip Code:63131-2064
Practice Address - Country:US
Practice Address - Phone:314-628-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025023157152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist