Provider Demographics
NPI:1609830421
Name:LIPKA, DEBBY ANN (DC)
Entity Type:Individual
Prefix:
First Name:DEBBY
Middle Name:ANN
Last Name:LIPKA
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 1:35517 23 MILE RD
Mailing Address - Street 2:
Mailing Address - City:NEW BALTIMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48047-3603
Mailing Address - Country:US
Mailing Address - Phone:586-725-8700
Mailing Address - Fax:586-725-6251
Practice Address - Street 1:35517 23 MILE RD
Practice Address - Street 2:
Practice Address - City:NEW BALTIMORE
Practice Address - State:MI
Practice Address - Zip Code:48047-3603
Practice Address - Country:US
Practice Address - Phone:586-725-8700
Practice Address - Fax:586-725-6251
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301006697111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950E05205OtherBCBS
MI0E05205Medicare ID - Type Unspecified
MI950E05205OtherBCBS