Healthcare Provider Details

I. General information

NPI: 1326469057
Provider Name (Legal Business Name): RIZZA CHIROPRACTIC AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2013
Last Update Date: 10/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 MIDDLEBURY RD SUITE B
MIDDLEBURY CT
06762-2562
US

IV. Provider business mailing address

590 MIDDLEBURY RD SUITE B
MIDDLEBURY CT
06762-2562
US

V. Phone/Fax

Practice location:
  • Phone: 203-577-2095
  • Fax: 203-577-2098
Mailing address:
  • Phone: 203-577-2095
  • Fax: 203-577-2098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number001902
License Number StateCT

VIII. Authorized Official

Name: DR. JASON P RIZZA
Title or Position: OWNER
Credential: D.C. M.S.
Phone: 203-577-2095