Provider Demographics
NPI:1811628274
Name:CHIGLO, CHRISTOPHER TY (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:TY
Last Name:CHIGLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 N ELLIS ST
Mailing Address - Street 2:
Mailing Address - City:GROESBECK
Mailing Address - State:TX
Mailing Address - Zip Code:76642-1308
Mailing Address - Country:US
Mailing Address - Phone:254-729-2500
Mailing Address - Fax:254-729-2097
Practice Address - Street 1:105 N ELLIS ST
Practice Address - Street 2:
Practice Address - City:GROESBECK
Practice Address - State:TX
Practice Address - Zip Code:76642-1308
Practice Address - Country:US
Practice Address - Phone:254-729-2500
Practice Address - Fax:254-729-2097
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15191111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor