Provider Demographics
NPI:1710939921
Name:CHRIS BRADLEY WIGTON DC PC
Entity Type:Organization
Organization Name:CHRIS BRADLEY WIGTON DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:B
Authorized Official - Last Name:WIGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-437-6808
Mailing Address - Street 1:420 9TH ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323-1110
Mailing Address - Country:US
Mailing Address - Phone:814-437-6808
Mailing Address - Fax:814-432-3601
Practice Address - Street 1:420 9TH ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-1110
Practice Address - Country:US
Practice Address - Phone:814-437-6808
Practice Address - Fax:814-432-3601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA680741OtherBCBS
PA680741OtherBCBS