Provider Demographics
NPI:1720636079
Name:TOLPA, SYDNEE (DC)
Entity Type:Individual
Prefix:
First Name:SYDNEE
Middle Name:
Last Name:TOLPA
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 1:1803 CROWNE COMMONS WAY
Mailing Address - Street 2:SUITE A1
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-6110
Mailing Address - Country:US
Mailing Address - Phone:843-737-6960
Mailing Address - Fax:
Practice Address - Street 1:3417 SHELBY RAY CT STE C
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5895
Practice Address - Country:US
Practice Address - Phone:843-737-6960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-29
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4466111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty