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Individual
JOHN R FAZZIO
Active
Individual
JOHN R FAZZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC DACNB
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6669
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8F9255
MEDICARE PROVIDER NUMBER
TX
Enumeration date
10/02/2006
Last updated
12/04/2008
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