Individual
DR. MASSIMO BIANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
7707 PRESTON HWY, LOUISVILLE, KY 40219-3138
(502) 962-2277
(502) 962-1001
Mailing address
7707 PRESTON HWY, LOUISVILLE, KY 40219-3138
(502) 962-2277
(502) 962-1001
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4783
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000351377
ANTHEM BCBS
—
01
—
1169461
PASSPORT GROUP ID
—
01
—
50003950
PASSPORT PIN
—
01
—
7350315
AETNA
—
05
—
85002954
—
KY
Enumeration date
09/01/2005
Last updated
02/20/2017
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