Provider Demographics
NPI:1235334954
Name:COUNTS, TELLI LAPONZA (DC)
Entity Type:Individual
Prefix:DR
First Name:TELLI
Middle Name:LAPONZA
Last Name:COUNTS
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 1:4408 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-5970
Mailing Address - Country:US
Mailing Address - Phone:803-446-7404
Mailing Address - Fax:803-799-9473
Practice Address - Street 1:4408 N MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-5970
Practice Address - Country:US
Practice Address - Phone:803-446-7404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3124111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA27500281Medicare PIN