Provider Demographics
NPI:1114338712
Name:BIGBIE, SHANNON PATRICIA (DC)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:PATRICIA
Last Name:BIGBIE
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 1:943 OLD CHEROKEE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-9042
Mailing Address - Country:US
Mailing Address - Phone:803-600-3784
Mailing Address - Fax:803-356-9389
Practice Address - Street 1:943 OLD CHEROKEE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-9042
Practice Address - Country:US
Practice Address - Phone:803-600-3784
Practice Address - Fax:803-356-9389
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3931111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor