Provider Demographics
NPI:1760802300
Name:VIGIL ENTERPRISES
Entity Type:Organization
Organization Name:VIGIL ENTERPRISES
Other - Org Name:VIGIL FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:THEODORE
Authorized Official - Last Name:VIGIL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:719-738-3808
Mailing Address - Street 1:110 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WALSENBURG
Mailing Address - State:CO
Mailing Address - Zip Code:81089-2020
Mailing Address - Country:US
Mailing Address - Phone:719-738-3808
Mailing Address - Fax:719-738-3808
Practice Address - Street 1:110 E 6TH ST
Practice Address - Street 2:
Practice Address - City:WALSENBURG
Practice Address - State:CO
Practice Address - Zip Code:81089-2020
Practice Address - Country:US
Practice Address - Phone:719-738-3808
Practice Address - Fax:719-738-3808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5081111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty