Provider Demographics
NPI:1285739052
Name:FIORINO, JOSEPH CHARLES JR (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CHARLES
Last Name:FIORINO
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:139 E WALNUT ST
Mailing Address - Street 2:TOWN AND COUNTRY PLAZA
Mailing Address - City:THAYER
Mailing Address - State:MO
Mailing Address - Zip Code:65791-1516
Mailing Address - Country:US
Mailing Address - Phone:417-264-7610
Mailing Address - Fax:417-264-7619
Practice Address - Street 1:139 E WALNUT ST
Practice Address - Street 2:TOWN AND COUNTRY PLAZA
Practice Address - City:THAYER
Practice Address - State:MO
Practice Address - Zip Code:65791-1516
Practice Address - Country:US
Practice Address - Phone:417-264-7610
Practice Address - Fax:417-264-7619
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006011828111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor