Provider Demographics
NPI:1043560592
Name:RIGGLEMAN, EVAN C (DC)
Entity Type:Individual
Prefix:MR
First Name:EVAN
Middle Name:C
Last Name:RIGGLEMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W JUBAL EARLY DR STE A
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6501
Mailing Address - Country:US
Mailing Address - Phone:540-678-1212
Mailing Address - Fax:540-678-1123
Practice Address - Street 1:611 W JUBAL EARLY DR STE A
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6501
Practice Address - Country:US
Practice Address - Phone:540-678-1212
Practice Address - Fax:540-678-1123
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557016111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor