Provider Demographics
NPI:1306907993
Name:KOEPFLER, TAMMY JEAN (DC)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:JEAN
Last Name:KOEPFLER
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 1:352 S. WILLOWBROOK RD
Mailing Address - Street 2:STE D
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036
Mailing Address - Country:US
Mailing Address - Phone:517-279-2845
Mailing Address - Fax:517-278-2847
Practice Address - Street 1:352 S WILLOWBROOK RD
Practice Address - Street 2:STE D
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-8856
Practice Address - Country:US
Practice Address - Phone:517-279-2845
Practice Address - Fax:517-278-2847
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIV08997Medicare UPIN
MIP26110002Medicare ID - Type Unspecified
MI0P26110Medicare ID - Type UnspecifiedGROUP