Provider Demographics
NPI:1386736353
Name:BISS, JOHN (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:BISS
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 1:612 OAK ST
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-3528
Mailing Address - Country:US
Mailing Address - Phone:724-864-5660
Mailing Address - Fax:724-864-5664
Practice Address - Street 1:612 OAK ST
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-3528
Practice Address - Country:US
Practice Address - Phone:724-864-5660
Practice Address - Fax:724-864-5664
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC0023571111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000890807-0001Medicaid
PA000890807-0001Medicaid