Provider Demographics
NPI:1326469057
Name:RIZZA CHIROPRACTIC AND WELLNESS, LLC
Entity Type:Organization
Organization Name:RIZZA CHIROPRACTIC AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:P
Authorized Official - Last Name:RIZZA
Authorized Official - Suffix:
Authorized Official - Credentials:DC MS
Authorized Official - Phone:203-577-2095
Mailing Address - Street 1:590 MIDDLEBURY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-2562
Mailing Address - Country:US
Mailing Address - Phone:203-577-2095
Mailing Address - Fax:203-577-2098
Practice Address - Street 1:590 MIDDLEBURY RD
Practice Address - Street 2:SUITE B
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-2562
Practice Address - Country:US
Practice Address - Phone:203-577-2095
Practice Address - Fax:203-577-2098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-24
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001902305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service