Provider Demographics
NPI:1609048750
Name:CHRISS J SIGAFOOSE, PA
Entity Type:Organization
Organization Name:CHRISS J SIGAFOOSE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SIGAFOOSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-493-2688
Mailing Address - Street 1:1694 TAMIAMI TRL S
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-1633
Mailing Address - Country:US
Mailing Address - Phone:941-493-2688
Mailing Address - Fax:941-493-2783
Practice Address - Street 1:1694 TAMIAMI TRL S
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-1633
Practice Address - Country:US
Practice Address - Phone:941-493-2688
Practice Address - Fax:941-493-2783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL97807OtherBCBS ID
FLK4569OtherMEDICARE GROUP
FLT55960Medicare UPIN
FLK4569OtherMEDICARE GROUP