Individual
DR. JOHN JOSEPH DERICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
5965 DOLVIN LANE, BUFORD, GA 30518-1207
(770) 935-8533
Mailing address
5965 DOLVIN LANE, BUFORD, GA 30518-1207
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR004683
GA
Other
Enumeration date
03/11/2009
Last updated
03/11/2009
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