Provider Demographics
NPI:1235139254
Name:SIGAFOOSE, TINA A (DC)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:A
Last Name:SIGAFOOSE
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 1:6997 LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17364-9208
Mailing Address - Country:US
Mailing Address - Phone:717-225-1017
Mailing Address - Fax:717-225-5709
Practice Address - Street 1:6997 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:PA
Practice Address - Zip Code:17364-9208
Practice Address - Country:US
Practice Address - Phone:717-225-1017
Practice Address - Fax:717-225-5709
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002559L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02722200OtherBLUE CROSS ID
PABLUE SHIELDOtherB.S. ID
PA442678Medicare ID - Type UnspecifiedMEDICARE ID