Provider Demographics
NPI:1477608602
Name:TIERNEY, NORMA LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:LEE
Last Name:TIERNEY
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 1:2441 RT 46 SOUTH
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:OH
Mailing Address - Zip Code:44047-8509
Mailing Address - Country:US
Mailing Address - Phone:440-576-7447
Mailing Address - Fax:440-576-7447
Practice Address - Street 1:2441 RT 46 SOUTH
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:OH
Practice Address - Zip Code:44047-8509
Practice Address - Country:US
Practice Address - Phone:440-576-7447
Practice Address - Fax:440-576-7447
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH568111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000115425OtherANTHEM BCBS
OH0351122Medicaid
T10385901Medicare ID - Type Unspecified