Provider Demographics
NPI:1548322944
Name:GIGNAC, TODD WERNER (DC)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:WERNER
Last Name:GIGNAC
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 1:2255 CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-4708
Mailing Address - Country:US
Mailing Address - Phone:352-720-3672
Mailing Address - Fax:760-720-2930
Practice Address - Street 1:2255 CRESCENT DR
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-4708
Practice Address - Country:US
Practice Address - Phone:352-720-3672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13189111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor