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General NPI Number Information
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NPI Number | 1760635064
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Entity Type | Individual
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Provider Name | JUSTIN GEOFFREY RIZZO D.C.
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Gender | Male
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Dates
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Enumeration Date | 10/30/2008
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Last Update Date | 09/25/2018
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Provider Practice Location Address
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Address Line | 160 BENMONT AVE STE 30
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City | BENNINGTON
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State | VT
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Zip | 05201-1899
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Country | US
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Telephone | 802-447-2110
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Fax | 802-447-2115
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Provider Business Mailing Address
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Address Line | 3 DWIGHT AVE
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City | CLINTON
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State | NY
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Zip | 13323-1613
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Country | US
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Telephone | 315-525-9393
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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 | 011714
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3968
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 006.0134120
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License Number State | VT
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