Provider Demographics
NPI:1811312929
Name:BIGGERSTAFF FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:BIGGERSTAFF FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/D.C.
Authorized Official - Prefix:
Authorized Official - First Name:GILLIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BIGGERSTAFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:641-426-0365
Mailing Address - Street 1:101 N MAIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHARLES CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50616-2014
Mailing Address - Country:US
Mailing Address - Phone:641-426-0365
Mailing Address - Fax:641-715-1114
Practice Address - Street 1:101 N MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CHARLES CITY
Practice Address - State:IA
Practice Address - Zip Code:50616-2014
Practice Address - Country:US
Practice Address - Phone:641-426-0365
Practice Address - Fax:641-715-1114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06766111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty