Provider Demographics
NPI:1144377219
Name:PIZZO, JOHN J (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:PIZZO
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 1:108 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-4214
Mailing Address - Country:US
Mailing Address - Phone:802-479-3206
Mailing Address - Fax:802-479-3348
Practice Address - Street 1:108 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-4214
Practice Address - Country:US
Practice Address - Phone:802-479-3206
Practice Address - Fax:802-479-3348
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT715111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0703255-001OtherCIGNA
VT035-8798OtherBLUE CROSS BLUE SHIELD
VT035-8798OtherBLUE CROSS BLUE SHIELD