Provider Demographics
NPI:1861631707
Name:BIZAN, ADAM ROMAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:ROMAN
Last Name:BIZAN
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 1:124 SCHOHARIE PLANK RD E
Mailing Address - Street 2:PO BOX 532
Mailing Address - City:ALTAMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12009-6224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2825 WENDELL BLVD
Practice Address - Street 2:
Practice Address - City:WENDELL
Practice Address - State:NC
Practice Address - Zip Code:27591-6904
Practice Address - Country:US
Practice Address - Phone:919-366-3111
Practice Address - Fax:919-366-3366
Is Sole Proprietor?:No
Enumeration Date:2009-02-17
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3908111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor