Provider Demographics
NPI:1154513513
Name:TIEPERMAN, LORI LEAH (D C)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:LEAH
Last Name:TIEPERMAN
Suffix:
Gender:F
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2612 DEERHOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6811
Mailing Address - Country:US
Mailing Address - Phone:214-636-7194
Mailing Address - Fax:
Practice Address - Street 1:6201 TECHNOLOGY DR
Practice Address - Street 2:SUITE 107
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-3264
Practice Address - Country:US
Practice Address - Phone:214-636-7194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10184111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor