Provider Demographics
NPI:1780715672
Name:WIGGINS CHIROPRACTIC
Entity type:Organization
Organization Name:WIGGINS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:432-268-1711
Mailing Address - Street 1:PO BOX 2509
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79721-2509
Mailing Address - Country:US
Mailing Address - Phone:432-268-1711
Mailing Address - Fax:432-268-9118
Practice Address - Street 1:1800 SCURRY ST
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-5402
Practice Address - Country:US
Practice Address - Phone:432-268-1711
Practice Address - Fax:432-268-9118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6347111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00900NMedicare ID - Type Unspecified
TXU47509Medicare UPIN