Provider Demographics
NPI:1336249051
Name:SIGVALDSON, TANYA LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:TANYA
Middle Name:LYNN
Last Name:SIGVALDSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 STADIUM TRACE PKWY STE 260
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-4525
Mailing Address - Country:US
Mailing Address - Phone:205-982-6880
Mailing Address - Fax:
Practice Address - Street 1:5330 STADIUM TRACE PKWY STE 260
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244
Practice Address - Country:US
Practice Address - Phone:205-982-6880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2054111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
051519142Other46-4853529
AL051519142Medicare Oscar/Certification