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General NPI Number Information
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NPI Number | 1538439237
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Entity Type | Individual
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Provider Name | JASON P RIZZA DC
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Gender | Male
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Dates
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Enumeration Date | 01/11/2012
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Last Update Date | 01/11/2012
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Provider Practice Location Address
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Address Line | 590 MIDDLEBURY RD SUITE 2
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City | MIDDLEBURY
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State | CT
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Zip | 06762-2562
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Country | US
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Telephone | 203-577-2095
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Fax |
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Provider Business Mailing Address
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Address Line | 124 ALBERTA ST
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City | WATERBURY
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State | CT
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Zip | 06708-3412
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1902
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License Number State | CT
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