Provider Demographics
NPI:1720130438
Name:JOHN J. PIZZO, DC, PC
Entity type:Organization
Organization Name:JOHN J. PIZZO, DC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PIZZO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:802-479-3206
Mailing Address - Street 1:108 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-4214
Mailing Address - Country:US
Mailing Address - Phone:802-479-3206
Mailing Address - Fax:802-479-3348
Practice Address - Street 1:108 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-4214
Practice Address - Country:US
Practice Address - Phone:802-479-3206
Practice Address - Fax:802-479-3348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006-0000715111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT035-8798OtherBLUE CROSS BLUE SHIELD
VT0703255-001OtherCIGNA
VTPIVT8798Medicare ID - Type Unspecified