Provider Demographics
NPI:1194802264
Name:KLOPP-SILVA, LISA ROCHELLE (DC)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:ROCHELLE
Last Name:KLOPP-SILVA
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 1:1615 WADE HAMPTON BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-5062
Mailing Address - Country:US
Mailing Address - Phone:864-292-9853
Mailing Address - Fax:864-292-0562
Practice Address - Street 1:1615 WADE HAMPTON BLVD
Practice Address - Street 2:STE B
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-5062
Practice Address - Country:US
Practice Address - Phone:864-292-9853
Practice Address - Fax:864-292-0562
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2548111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor