Individual
MR. MARCO RICCOBONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSOT, OTR/L, ATP
Contact information
Practice address
172 MIDWAY CENTER, WOODWAY, TX 76712-7671
(254) 773-1226
Mailing address
172 MIDWAY CENTER, WOODWAY, TX 76712-1803
(254) 773-1226
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
120002
TX
247200000X
Other Technician
Primary
92965
—
Other
Enumeration date
10/27/2015
Last updated
02/08/2023
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