Individual
JACQUELINE ANN LAROCCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
261 MACK AVE, DETROIT, MI 48201-2417
(248) 968-3900
Mailing address
2516 TIVERTON DR, STERLING HEIGHTS, MI 48310-6970
(586) 292-4246
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
225100000X
MI
Other
Enumeration date
06/12/2018
Last updated
06/12/2018
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