Provider Demographics
NPI:1558547976
Name:LISA SIGLER LIDDLE
Entity Type:Organization
Organization Name:LISA SIGLER LIDDLE
Other - Org Name:BELTON CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:S
Authorized Official - Last Name:LIDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-338-7766
Mailing Address - Street 1:716 ANDERSON ST STE B
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:SC
Mailing Address - Zip Code:29627-2148
Mailing Address - Country:US
Mailing Address - Phone:864-338-7766
Mailing Address - Fax:
Practice Address - Street 1:716 ANDERSON ST STE B
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:SC
Practice Address - Zip Code:29627-2148
Practice Address - Country:US
Practice Address - Phone:864-338-7766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2063111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2063Medicaid
SCU637986132Medicare UPIN