Provider Demographics
NPI:1417269010
Name:LIISTRO, JOSEPH III (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:LIISTRO
Suffix:III
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 1:1205 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:TX
Mailing Address - Zip Code:75428-2613
Mailing Address - Country:US
Mailing Address - Phone:903-886-3100
Mailing Address - Fax:
Practice Address - Street 1:1205 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:TX
Practice Address - Zip Code:75428-2613
Practice Address - Country:US
Practice Address - Phone:903-886-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-12
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11519111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor