Individual
DR. JOHN JAMES BISACCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
802 INDUSTRIAL AVE, WILLISTON, VT 05495
(802) 863-2272
(802) 658-0823
Mailing address
PO BOX 669, 802 INDUSTRIAL AVE, WILLISTON, VT 05495
(802) 863-2272
(802) 658-0823
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
006000986
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015151
—
VT
01
—
29174
BCBS
VT
01
—
P00089364
MEDICARE RAILROAD PIN#
VT
Enumeration date
10/27/2006
Last updated
12/03/2010
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