Provider Demographics
NPI:1558061481
Name:LIPPKE, ERIC J (LMT)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:J
Last Name:LIPPKE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6013 S STERNE PKWY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2546
Mailing Address - Country:US
Mailing Address - Phone:720-940-6508
Mailing Address - Fax:
Practice Address - Street 1:6013 S STERNE PKWY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2546
Practice Address - Country:US
Practice Address - Phone:720-940-6508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0013381225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist