Individual
ALEXANDER CALLOCCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 MILLARD FARMER IND BLVD STE 100, NEWNAN, GA 30263-3168
(904) 538-0713
(904) 538-0714
Mailing address
10175 FORTUNE PKWY UNIT 903, JACKSONVILLE, FL 32256-6755
(904) 538-0713
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-139167
GA
Other
Enumeration date
10/08/2020
Last updated
10/08/2020
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