Provider Demographics
NPI:1962110502
Name:COOMBE, LIANNE (DC)
Entity type:Individual
Prefix:
First Name:LIANNE
Middle Name:
Last Name:COOMBE
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 1:806 S DOE TRL
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-8813
Mailing Address - Country:US
Mailing Address - Phone:989-330-3992
Mailing Address - Fax:
Practice Address - Street 1:330 S UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2525
Practice Address - Country:US
Practice Address - Phone:989-400-4477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301011292111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty