Provider Demographics
NPI:1073826533
Name:PAPE, TIANNE A (DC, MS)
Entity type:Individual
Prefix:DR
First Name:TIANNE
Middle Name:A
Last Name:PAPE
Suffix:
Gender:F
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 944
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-0944
Mailing Address - Country:US
Mailing Address - Phone:860-739-3400
Mailing Address - Fax:860-739-3600
Practice Address - Street 1:305 FLANDERS RD
Practice Address - Street 2:SUITE #6
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1743
Practice Address - Country:US
Practice Address - Phone:860-739-3600
Practice Address - Fax:860-739-3600
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1857111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition