Provider Demographics
NPI:1730383258
Name:SIGAFOOSE CHIROPRACTIC LIFE CENTER, INC.
Entity type:Organization
Organization Name:SIGAFOOSE CHIROPRACTIC LIFE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIGAFOOSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-225-6056
Mailing Address - Street 1:6997 LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17364-9208
Mailing Address - Country:US
Mailing Address - Phone:717-225-1017
Mailing Address - Fax:717-225-5709
Practice Address - Street 1:6997 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:PA
Practice Address - Zip Code:17364-9208
Practice Address - Country:US
Practice Address - Phone:717-225-1017
Practice Address - Fax:717-225-5709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002559L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA442678Medicare ID - Type Unspecified