Individual
DR. JOSEPH DISPENZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
503 1ST ST S, YELM, WA 98597-7634
(360) 400-3151
(360) 400-3150
Mailing address
PO BOX 656, RAINIER, WA 98576-0656
(360) 400-3151
(360) 400-3150
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
025202CH00002150
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330154719
FEDERAL CLINC TAX ID
WA
01
—
P00286072
RAILROAD MEDICARE NUMBER
WA
Enumeration date
05/31/2005
Last updated
04/16/2014
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