Provider Demographics
NPI:1881067619
Name:RIGGIN, JESSE (DC)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:RIGGIN
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:PO BOX 89
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19952-0089
Mailing Address - Country:US
Mailing Address - Phone:302-423-0674
Mailing Address - Fax:302-566-6046
Practice Address - Street 1:203 SHAW AVE
Practice Address - Street 2:
Practice Address - City:HARRINGTON
Practice Address - State:DE
Practice Address - Zip Code:19952-1220
Practice Address - Country:US
Practice Address - Phone:302-682-7975
Practice Address - Fax:302-566-6046
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-02
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000934111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor