Provider Demographics
NPI:1942671326
Name:RISOLDI, CHAD (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:
Last Name:RISOLDI
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 1:103A WILSHIRE WAY
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-8991
Mailing Address - Country:US
Mailing Address - Phone:814-934-6825
Mailing Address - Fax:
Practice Address - Street 1:2403 WOOTEN BLVD SW
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4463
Practice Address - Country:US
Practice Address - Phone:636-300-7636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4586111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor