Provider Demographics
NPI:1841378049
Name:JOHN M RIZZO D.C.
Entity type:Organization
Organization Name:JOHN M RIZZO D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER- SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIZZO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-472-6050
Mailing Address - Street 1:110 N CENTER ST
Mailing Address - Street 2:PO BOX 813
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-1622
Mailing Address - Country:US
Mailing Address - Phone:814-472-6050
Mailing Address - Fax:814-472-9490
Practice Address - Street 1:110 N CENTER ST
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-1622
Practice Address - Country:US
Practice Address - Phone:814-472-6050
Practice Address - Fax:814-472-9490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005143L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0013048330002Medicaid
PA0013048330002Medicaid
PA192960Medicare ID - Type Unspecified