Provider Demographics
NPI:1194828319
Name:BIGO-DEMILLIO, ANITA M (DC)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:M
Last Name:BIGO-DEMILLIO
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 1:330 WELDON ST
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-1851
Mailing Address - Country:US
Mailing Address - Phone:724-537-2445
Mailing Address - Fax:724-539-2909
Practice Address - Street 1:330 WELDON ST
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1851
Practice Address - Country:US
Practice Address - Phone:724-537-2445
Practice Address - Fax:724-539-2909
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC000829L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA202302805OtherCHIROPRACTOR
PA107192OtherHIGHMARK BC/BS