Provider Demographics
NPI:1225722275
Name:580 CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:580 CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:BIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:580-305-2009
Mailing Address - Street 1:PO BOX 2153
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73534-2153
Mailing Address - Country:US
Mailing Address - Phone:580-251-1701
Mailing Address - Fax:580-251-1701
Practice Address - Street 1:719 W WILLOW AVE STE 2
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-4951
Practice Address - Country:US
Practice Address - Phone:580-251-1701
Practice Address - Fax:580-251-1701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty