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Organization
TIFFANY RENAUD, INC.
Active
Organization
TIFFANY RENAUD, INC.
Active
Other names
Living Well Spinal Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY RENAUD D.C. (PRESIDENT)
(802) 658-6092
Entity
Organization
Contact information
Practice address
3000 WILLISTON RD, SUITE 3, SOUTH BURLINGTON, VT 05403-6082
(802) 658-6092
(802) 863-9565
Mailing address
3000 WILLISTON RD, SUITE 3, SOUTH BURLINGTON, VT 05403-6082
(802) 658-6092
(802) 863-9565
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0060000905
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TIFF00018436
BCBS
VT
01
—
VN3492
MEDICARE GROUP ID
VT
Enumeration date
05/01/2008
Last updated
05/08/2012
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