Provider Demographics
NPI:1720040579
Name:VISONE, RICHARD GUY (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:GUY
Last Name:VISONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:VISONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:108 SAMUEL DR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-3276
Mailing Address - Country:US
Mailing Address - Phone:724-924-9340
Mailing Address - Fax:
Practice Address - Street 1:376 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAMPUM
Practice Address - State:PA
Practice Address - Zip Code:16157-4313
Practice Address - Country:US
Practice Address - Phone:724-535-1025
Practice Address - Fax:724-535-1026
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABC009127111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA262484OtherHIGHMARK BC/BS
PA262484OtherHIGHMARK BC/BS