Provider Demographics
NPI:1932207693
Name:RAZZANO CHIROPRACTIC PC
Entity Type:Organization
Organization Name:RAZZANO CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:RAZZANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-296-0999
Mailing Address - Street 1:1007 SKYWAY DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-3050
Mailing Address - Country:US
Mailing Address - Phone:704-296-0999
Mailing Address - Fax:704-289-2596
Practice Address - Street 1:1007 SKYWAY DR
Practice Address - Street 2:SUITE C
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-3050
Practice Address - Country:US
Practice Address - Phone:704-296-0999
Practice Address - Fax:704-289-2596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3021111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085MNOtherBLUE CROSS BLUE SHIELD
NC89085MNMedicaid
NC085MNOtherBLUE CROSS BLUE SHIELD