Provider Demographics
NPI:1740599760
Name:LIPTAK, LOIS FRANCES (RN, LCMT, CPT, CLP)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:FRANCES
Last Name:LIPTAK
Suffix:
Gender:F
Credentials:RN, LCMT, CPT, CLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 FIRETHORN LN
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-6238
Mailing Address - Country:US
Mailing Address - Phone:843-686-6428
Mailing Address - Fax:843-686-6428
Practice Address - Street 1:30 NEW ORLEANS RD
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-4715
Practice Address - Country:US
Practice Address - Phone:843-686-6428
Practice Address - Fax:843-686-6428
Is Sole Proprietor?:No
Enumeration Date:2010-09-26
Last Update Date:2010-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1581163WM1400X
SCRN34656163WM1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)