Provider Demographics
NPI:1497968630
Name:TIGER FAMILY CHIROPRACTIC AND WELLNESS CENTER
Entity Type:Organization
Organization Name:TIGER FAMILY CHIROPRACTIC AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SIGNAIGO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-268-1704
Mailing Address - Street 1:3600 INTERSTATE 70 DR SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-6583
Mailing Address - Country:US
Mailing Address - Phone:573-268-1704
Mailing Address - Fax:
Practice Address - Street 1:3600 INTERSTATE 70 DR SE
Practice Address - Street 2:SUITE A
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6583
Practice Address - Country:US
Practice Address - Phone:573-268-1704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006034083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO=========OtherEIN