Provider Demographics
NPI:1427068998
Name:RIGGIO, BRITTANI LEAH (DC)
Entity type:Individual
Prefix:DR
First Name:BRITTANI
Middle Name:LEAH
Last Name:RIGGIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62858
Mailing Address - Country:US
Mailing Address - Phone:618-665-3070
Mailing Address - Fax:618-665-3072
Practice Address - Street 1:101 S. MAIN STREET
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:IL
Practice Address - Zip Code:62858
Practice Address - Country:US
Practice Address - Phone:618-665-3070
Practice Address - Fax:618-665-3072
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-010588111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL20-4649831OtherFEIN #