Individual
DR. JOHN RALPH IACOVINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
149 LEGACY WOODS DR, WALLACE, NC 28466-2398
(910) 285-5342
Mailing address
149 LEGACY WOODS DR, WALLACE, NC 28466-2398
(910) 285-5342
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
119396
NC
Other
Enumeration date
05/21/2012
Last updated
05/21/2012
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