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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