Provider Demographics
NPI:1235895863
Name:TIPPETTS, COURTNEY ANNELIESE (DC)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:ANNELIESE
Last Name:TIPPETTS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:ANNELIESE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1251 MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-4917
Mailing Address - Country:US
Mailing Address - Phone:330-928-2273
Mailing Address - Fax:
Practice Address - Street 1:1251 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-4917
Practice Address - Country:US
Practice Address - Phone:330-928-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05135111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor