Provider Demographics
NPI:1265038426
Name:LUPPO, PARIZ JORDAN (BS, DC, PLLC)
Entity Type:Individual
Prefix:
First Name:PARIZ
Middle Name:JORDAN
Last Name:LUPPO
Suffix:
Gender:F
Credentials:BS, DC, PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 S LIVERNOIS RD STE B-11
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2580
Mailing Address - Country:US
Mailing Address - Phone:248-963-2904
Mailing Address - Fax:
Practice Address - Street 1:455 S LIVERNOIS RD STE B-11
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2580
Practice Address - Country:US
Practice Address - Phone:248-963-2904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301011027111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor