Provider Demographics
NPI:1790969723
Name:PAPENBROCK, LISA (DC)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:PAPENBROCK
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 1:3446 MELWOOD STREET
Mailing Address - Street 2:APARTMENT #1
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219
Mailing Address - Country:US
Mailing Address - Phone:315-730-0970
Mailing Address - Fax:
Practice Address - Street 1:9062 RINGEISEN RD
Practice Address - Street 2:
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-2710
Practice Address - Country:US
Practice Address - Phone:315-730-0970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011502111N00000X
PADC009882111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor