Provider Demographics
NPI:1881713725
Name:RIGG, TIMOTHY J (DC, MTAA)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:J
Last Name:RIGG
Suffix:
Gender:M
Credentials:DC, MTAA
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 334
Mailing Address - Street 2:
Mailing Address - City:FORISTELL
Mailing Address - State:MO
Mailing Address - Zip Code:63348-0334
Mailing Address - Country:US
Mailing Address - Phone:636-463-1122
Mailing Address - Fax:636-463-1122
Practice Address - Street 1:1016 S SERVICE RD
Practice Address - Street 2:
Practice Address - City:FORISTELL
Practice Address - State:MO
Practice Address - Zip Code:63348
Practice Address - Country:US
Practice Address - Phone:636-463-1122
Practice Address - Fax:636-463-1122
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003031903111N00000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO685962OtherHEALTHLINK
MO665701OtherUNITEDHEALTHCARE - ACN
MO190993OtherBLUECROSS - BLUESHIELD