Provider Demographics
NPI:1871708354
Name:VIZURI HEALTH CENTER PC
Entity type:Organization
Organization Name:VIZURI HEALTH CENTER PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHENCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:802-878-8330
Mailing Address - Street 1:PO BOX 979
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-0979
Mailing Address - Country:US
Mailing Address - Phone:802-878-8330
Mailing Address - Fax:802-878-8344
Practice Address - Street 1:205 CORNERSTONE DR
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-4035
Practice Address - Country:US
Practice Address - Phone:802-878-8330
Practice Address - Fax:802-878-8344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006-0000870111N00000X, 111NN0400X, 111NN1001X, 111NR0400X
VT1010016293363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT70390OtherBLUE CROSS/BLUE SHIELD
VT5730340OtherFIRST HEALTH
VTT87083OtherCIGNA
VT03036OtherCBA
VT18942OtherBCBS
VT80705OtherGREAT WEST
VT80705OtherGREAT WEST